Insight Global

Program Integrity Medical Coding Reviewer III The Program Integrity Medical Coding Reviewer III generates comprehensive and concise in-depth reporting and analysis to track performance related to the Pre-Pay and Post-Paid Processes. Essential functions include: Providing provider pre-pay production and progress reports and coordinating with management and team on recommendations for further actions and/or resolutions to increase team performance. Recommending process or procedure changes while building strong relationships with cross-departmental teams such as Claims, Configuration, Health Partners, and IT on identified internal system gaps. Demonstrating leadership ability, including mentoring Program Integrity Claims Analysts to identify and perform oversight and monitoring of claims decisions based on documentation. Identifying and assisting in correction of organizational workflow and process inefficiencies. Serving as the primary resource for provider pre-pay team....

Auditor Insight Global is seeking an auditor to accurately audit hospital inpatient, ambulatory surgery, observation, and outpatient encounters to ensure appropriate reimbursement, research accuracy, and compliance with federal and state regulations using ICD-10-CM/PCS and CPT-4 coding systems. Responsibilities include, but are not limited to: Audit ICD-10 diagnostic codes and CPT-4 procedure codes for outpatient, ambulatory surgery, and observation encounters Audit complex inpatient cases including trauma, rehab, neurology, and critical care Ensure accurate APR-DRG, SOI/ROM, and POA assignment Serve as a clinical coding subject matter expert and resource to coding specialists Provide education, training, and guidance to coding staff Monitor coding quality accuracy and productivity rates Conduct specialized and focused audits as needed Collaborate with CDI, medical staff, and clinical documentation specialists Assist with writing appropriate coding queries Ensure...

A health system in North Florida seeks a professional coder to focus on pro-fee coding in adult cardiology. Responsibilities include coding work queues for cardiac procedures and diagnostic testing while working entirely within Epic. Ideal candidates will have CPC certification, expertise in CPT and ICD-10, and 3-5 years of cardiology coding experience. This role provides flexibility in workload selection, maintaining a diverse and inclusive workplace culture. #J-18808-Ljbffr

Insight Global is seeking a Medical Coding Auditor for a large healthcare client in Houston, TX. This role is responsible for performing second-level reviews of surgical cases submitted by coders through a designated work queue, with a primary focus on validating the accuracy of surgical procedure codes. The auditor will review cases across multiple surgical specialties, including cardiology and urology, on a daily basis, pulling claims by individual coder to conduct detailed audits. The position requires strong surgical coding experience to determine coding accuracy and compliance, audit coder performance, and ensure quality standards are met. When coders fall below a 95% accuracy threshold, the auditor will provide targeted education, including setting up training sessions and developing PowerPoint presentations to educate coders on new or updated codes. Additionally, this role is responsible for staying current on coding changes related to surgical procedures and distributing...

Job Description Insight Global is seeking 1 Inpatient Coder to support a large healthcare system based out of Annapolis, MD. The Inpatient Medical Coder under the supervision of the Manager of Coding and Data Quality accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems. Essential Job Duties: The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. Analyzes inpatient cases, identifies and assigns ICD-10 diagnostic and PCS procedural codes for the purpose of reimbursement, research and compliance with federal and state regulations. Demonstrates comprehensive knowledge of coding nomenclature to...

Job Description Insight Global is seeking a Medical Coding Auditor for a large healthcare client in Houston, TX. This role is responsible for performing second-level reviews of surgical cases submitted by coders through a designated work queue, with a primary focus on validating the accuracy of surgical procedure codes. The auditor will review cases across multiple surgical specialties, including cardiology and urology, on a daily basis, pulling claims by individual coder to conduct detailed audits. The position requires strong surgical coding experience to determine coding accuracy and compliance, audit coder performance, and ensure quality standards are met. When coders fall below a 95% accuracy threshold, the auditor will provide targeted education, including setting up training sessions and developing PowerPoint presentations to educate coders on new or updated codes. Additionally, this role is responsible for staying current on coding changes related to surgical procedures...

Insight Global is seeking 1 Inpatient Coder to support a large healthcare system based out of Annapolis, MD. The Inpatient Medical Coder under the supervision of the Manager of Coding and Data Quality accurately codes hospital inpatient accounts for the purpose of appropriate reimbursement, research, statistics and compliance to federal and state regulations in accordance with established ICD-10-CM/PCS coding classification systems. Essential Job Duties: The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. - Analyzes inpatient cases, identifies and assigns ICD-10 diagnostic and PCS procedural codes for the purpose of reimbursement, research and compliance with federal and state regulations. - Demonstrates comprehensive knowledge of coding nomenclature to ensure accurate...

The Program Integrity Medical Coding Reviewer III generates comprehensive and concise in-depth reporting and analysis to track performance related to the Pre-Pay and Post-Paid Processes. Essential Functions • Provide Provider Pre Pay production and progress reports and coordinate with management and team on recommendation for further actions and/or resolutions in order to increase team performance • Recommend process or procedure changes while building strong relationships with cross departmental teams such as Claims, Configuration, Health Partners, and IT on identified internal system gaps • Demonstrate leadership ability, including mentoring Program Integrity Claims Analysts to identify and perform oversight and monitoring of claims decisions based on documentation • Identify and assist in correction of organizational workflow and process inefficiencies • Serve as the primary resource for provider pre-pay team • Use concepts and knowledge of CPT, ICD10, HCPCS, DRG,...

Insight Global is seeking a professional coder to join a large regional health system in North Florida. This role focuses on pro-fee coding for adult cardiology, with responsibilities centered around coding work queues for cardiac procedures, diagnostic testing, and E&M services, including face-to-face encounters. The coder will support all cardiology and cardiac specialty-related services, working 100% within Epic. The position offers flexibility in workload selection, allowing the coder to choose between reviewing the most recent or older dates of service We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and...

Job Description The Program Integrity Medical Coding Reviewer III generates comprehensive and concise in-depth reporting and analysis to track performance related to the Pre-Pay and Post-Paid Processes. Essential Functions • Provide Provider Pre Pay production and progress reports and coordinate with management and team on recommendation for further actions and/or resolutions in order to increase team performance • Recommend process or procedure changes while building strong relationships with cross departmental teams such as Claims, Configuration, Health Partners, and IT on identified internal system gaps • Demonstrate leadership ability, including mentoring Program Integrity Claims Analysts to identify and perform oversight and monitoring of claims decisions based on documentation • Identify and assist in correction of organizational workflow and process inefficiencies • Serve as the primary resource for provider pre-pay team • Use concepts and...

A leading healthcare staffing company is seeking a Medical Coding Auditor in Houston, TX. This role involves reviewing surgical cases to verify the accuracy of coding and providing educational support to coders. Ideal candidates will have 2-5+ years of cardiology coding experience, be CPC or CCS certified, and possess a strong background in various surgical specialties. The position promotes a diverse and inclusive environment where all candidates are considered regardless of their background. #J-18808-Ljbffr

Insight Global is searching for Experienced PB/Pro Fee Medical Coders to support one of our largest healthcare clients in the Southeast. These individuals will work remotely in EST with flexible start times between 6AM-9AM EST. The position is specifically dedicated to the Orthopedic E/M work queue. Responsibilities include coding denials, assisting with coding audits, and collaborating with teammates on complex cases. Candidates must hold an active CPC, CCS, RHIA, or RHIT certification and be certified through HEMA or AAPC. Must Haves: At least 5 years of coding experience CPC Certification (CCS can replace this requirement) Experience with Orthopedic E/M and minor office procedures Details: Seniority level: Not Applicable Employment type: Contract Job function: Healthcare Provider Industries: Hospitals and Healthcare This job is currently active. Apply now to increase your chances of being considered. #J-18808-Ljbffr

Job Description Insight Global is seeking a professional coder to join a large regional health system in North Florida. This role focuses on pro-fee coding for adult cardiology, with responsibilities centered around coding work queues for cardiac procedures, diagnostic testing, and E&M services, including face-to-face encounters. The coder will support all cardiology and cardiac specialty–related services, working 100% within Epic. The position offers flexibility in workload selection, allowing the coder to choose between reviewing the most recent or older dates of service. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender...

A leading healthcare service provider in Chicago is seeking a Coding Auditor to ensure quality and accuracy in coding practices. The ideal candidate will have 2-3 years of experience in ICD-10 and CPT coding, including auditing and clinical expertise. Responsibilities include conducting audits, providing education, and supporting compliance projects. Joining this organization means becoming part of a diverse and inclusive team where everyone's contributions are valued. #J-18808-Ljbffr

Job Description Conduct audits to evaluate documentation quality, accuracy of charge code assignment, and financial billing statements. Support the Compliance Officer with projects assigned from internal and external sources. Perform Medicaid, Medicare, and other third-party payer audits as assigned. Respond to physician and clinic questions regarding current ICD-10 and CPT guidelines. Assist with outpatient coding as needed. Provide coding education, training, and updates to coding staff, physicians, and clinics as assigned. Support the coordination and compilation of data required for regulatory agencies and accreditation processes. Review charge master updates and additions to ensure appropriate and accurate ICD-10 and CPT code assignment. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters....

Insight Global is seeking a professional coder to join a large regional health system in North Florida. This role works fully within Epic, supporting a high-volume behavioral health coding queue. The coder will rotate across inpatient services, neuro/psych testing, and other outpatient work, while coding E/M services and hospital-based consults for physicians across multiple specialties. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or...

The Professional coder will be responsible for handling clinic charges, scrubbing chart for completeness, reviewing diagnoses codes, verifying procedures, along with communicating with providers regarding missing info and working edits. We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form . The EEOC "Know Your Rights" Poster is available here . To learn more...

Our client is seeking experienced Inpatient Coders to support high-volume, complex hospital systems. This role is responsible for accurate ICD10CM and ICD10PCS coding of inpatient encounters in accordance with official coding guidelines, regulatory requirements, and client-specific workflows. Coders must consistently meet both productivity and quality standards in large hospital environments. Key Responsibilities - Assign accurate ICD10CM and ICD10PCS codes for inpatient records following official coding guidelines, UHDDS guidelines, and CMS directives - Abstract and enter coded data into client electronic medical record systems - Assign Present on Admission (POA) indicators in accordance with AHA guidelines - Query providers to clarify conflicting, incomplete, or ambiguous clinical documentation when appropriate - Collaborate with Clinical Documentation Integrity (CDI) and Revenue Cycle teams to resolve documentation and coding issues - Identify and communicate...

A healthcare staffing firm in Texas is seeking experienced Inpatient Coders to support high-volume hospital systems. This role involves accurate coding of inpatient encounters according to official guidelines and maintaining productivity standards. Candidates must possess an active CCS credential and have over 3 years of inpatient coding experience. The ideal candidate should be able to adapt to shifting workloads. The position offers a collaborative environment to improve documentation quality. #J-18808-Ljbffr

Job Description Our client is seeking experienced Inpatient Coders to support high-volume, complex hospital systems. This role is responsible for accurate ICD‑10‑CM and ICD‑10‑PCS coding of inpatient encounters in accordance with official coding guidelines, regulatory requirements, and client‑specific workflows. Coders must consistently meet both productivity and quality standards in large hospital environments. Key Responsibilities Assign accurate ICD‑10‑CM and ICD‑10‑PCS codes for inpatient records following official coding guidelines, UHDDS guidelines, and CMS directives Abstract and enter coded data into client electronic medical record systems Assign Present on Admission (POA) indicators in accordance with AHA guidelines Query providers to clarify conflicting, incomplete, or ambiguous clinical documentation when appropriate Collaborate with Clinical Documentation Integrity (CDI) and Revenue Cycle teams to resolve documentation and coding issues Identify and communicate...

A regional health system in North Florida is looking for a professional coder to support its behavioral health coding queue. The role involves coding for inpatient services and neuro/psych testing within EPIC, with high volume expectations. Candidates should have at least 2 years of coding experience and an active coding certification. A commitment to diversity and inclusion is emphasized, making this a pivotal opportunity for qualified professionals to thrive in a supportive work environment. #J-18808-Ljbffr

Insight Global is seeking a professional coder to join a large regional health system in North Florida. This role works fully within Epic, supporting a high-volume behavioral health coding queue. The coder will rotate across inpatient services, neuro/psych testing, and other outpatient work, while coding E/M services and hospital-based consults for physicians across multiple specialties. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or...

Insight Global is seeking an Auditor to accurately audit hospital inpatient, ambulatory surgery, observation, and outpatient encounters to ensure appropriate reimbursement, research accuracy, and compliance with federal and state regulations using ICD-10-CM/PCS and CPT-4 coding systems. Responsibilities include, but are not limited to: • Audit ICD-10 diagnostic codes and CPT-4 procedure codes for outpatient, ambulatory surgery, and observation encounters • Audit complex inpatient cases including trauma, rehab, neurology, and critical care • Ensure accurate APR-DRG, SOI/ROM, and POA assignment • Serve as a clinical coding subject matter expert and resource to coding specialists • Provide education, training, and guidance to coding staff • Monitor coding quality accuracy and productivity rates • Conduct specialized and focused audits as needed • Collaborate with CDI, medical staff, and clinical documentation specialists • Assist with writing appropriate coding queries •...

Insight Global is seeking an experienced Part-Time Medical Biller to support a healthcare organization with a focused payment posting project. This role requires a strong foundational understanding of medical billing processes to ensure accuracy and efficiency from day one. What You'll Be Working On: - Lead a payment posting project, ensuring payments are applied accurately and timely - Review and interpret EOBs (Explanation of Benefits) to resolve discrepancies - Verify patient insurance eligibility and benefits - Identify and research denials, underpayments, and posting errors - Collaborate with internal teams to ensure clean and accurate billing workflows This is an onsite position in Pleasanton, CA. Hours are Mon-Fri, 10am-3pm PST. You will be working a 25-hour work week at the hourly rate of $25/hr. Candidates will have access to medical, dental, and vision benefits from day one. There is also weekly payroll set up. This is a 3-month contract, with the...