5,874 jobs found in United States

General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. It assists with medical record reviews for HCC diagnoses, correct usage of various coding guidelines (ICD-10-CM, CPT, HCPCS) and federal and MA payor regulations, as well as clinical validation of appropriate supporting documentation.   Supervisory Responsibilities: This position has no supervisory responsibilities.   General Requirements: All duties performed will be done accurately and in a timely manner.   1.        Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. 2.        Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. 3.        Must...

The Manager holds a key leadership role in ensuring the accuracy, compliance, and efficiency of provider coding and documentation practices. This position is responsible for directing all aspects of provider coding operations and clinical documentation improvement initiatives to support accurate reimbursement and maintain data integrity across the organization. The Manager leads a team of certified coders and charge coordinators, partnering closely with providers, compliance, and revenue cycle teams to enhance documentation quality, strengthen coding accuracy, and drive continuous improvement in clinical and financial performance. Required Knowledge & Skills Education: Associate Degree or 2 years of college coursework Experience: Five years of related experience. Requires broad knowledge of complex systems and procedures. Licenses and Certifications *CERTIFIED CODING SPECIALIST Qualifications *Associate or bachelor's degree. RN preferred. *Five...

Whether you are looking to expand your current knowledge or looking to share your extensive skills with us, this could be the start of something amazing. We are a small, close knit team that works together to accomplish tasks daily. Qualifications: Knowledge in Surgery Billing and Coding Coding Certification- CASCC or COC preferred Experience with Microsoft 365 products Minimum 3 years experience in surgical billing Knowledge in all aspects of RCM Insurance credentialling- preferred Job Requirements: Coding and Charge Capture Insurance Claims Billing Resolution of rejections Coding reviews of denials Appeal assistance Coding reviews of documentation in question by the coding team Management of payor chart audits Insurance overpayment reviews Issuance of disputes as needed Ability to assist in aging follow on unpaid claims Address physician documentation matters Month end closing Utilization of reports Knowledge of and adherence to...

Knowledge of ICD-10-CM and CPT coding guidelines as well as state and federal Medicare reimbursement guidelines. Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulations.   Ability to read and interpret medical procedures and terminology.   Ability to develop training materials, make group presentations, and to train staff.   Ability to exercise independent judgment.   Excellent written and verbal communication skills to prepare reports and related documents and to maintain working relationships with physicians and other staff.   Ability to maintain confidentiality.   Proficiency in MS Office and patient management software   Self-directed and positive attitude essential.   Represents company in a manner that ensures a positive service image and tone for the organization.     Reviews elective surgeries performed from the previous week across...

Planned Parenthood Association of Utah is looking for a bold, mission-driven  Director of Revenue Cycle  who is ready to make a powerful impact on the future of reproductive healthcare in our state. This is a dynamic leadership role for someone who thrives on solving complex challenges, elevating systems, and building strong, motivated teams. You will play a pivotal role in strengthening our financial foundation—ensuring every visit, every service, and every patient experience is supported by accurate, efficient, and forward-thinking revenue cycle operations. As a key collaborator across Health Services, Finance, and administrative leadership, you’ll bring fresh ideas, innovation, and strategic insight to identify new revenue opportunities and optimize the resources that keep our mission strong. If you’re passionate about protecting access to essential healthcare and want your work to truly matter, this is your opportunity to make a lasting difference at Planned...

University of Colorado Medicine (CU Medicine) is the region’s largest and most comprehensive multi-specialty physician group practice. The CU Medicine team delivers business operations, revenue cycle and administrative services to support the patients of over 4,000 University of Colorado School of Medicine physicians and advanced practice providers. These providers bring their unparalleled expertise at the forefront of medicine to deliver trusted, compassionate health care services at primary and specialty care clinics as well as facilities operated by affiliate hospitals of the University of Colorado. We are seeking a detail-oriented and highly motivated Surgical Coding Denial Specialist to join our AR Surgery team. This role plays a critical part in protecting and optimizing revenue for CU Medicine providers by ensuring surgical claims are accurately reviewed, appealed, and resolved. This position offers the flexibility of being 100% remote , and qualified...

About Our Company AccuMed is the premier provider of litigation support including expert witness services for medical damages. We offer historical and future cost analysis to support quick and successful pre-litigation outcomes using our database of over 20 billion patient encounters to establish the reasonable value of healthcare costs. We provide powerful and transparent data to establish, refute, or defend the reasonable value of medical charges. Job Overview AccuMed is seeking an operationally driven and strategically minded professional to continue development and expansion of our largest business segment: Expert Witness Services . This role centers on delivering expert witness services to our clients, including the formation and defense of expert opinions related to the reasonable value of medical costs. The position will involve case-by-case analysis, deposition, and courtroom testimony. Candidates must be confident in articulating and defending their...

Healthcare Coding and Consulting Services (HCCS) is hiring  multiple full-time, experienced, and certified Pro Fee and Pro Clinic Coders  across several outpatient specialties. These are fully remote, direct-hire W-2 positions offering long-term stability and consistent, specialty-aligned work. We currently have multiple Pro Fee and Pro Clinic openings supporting specialties such as  Family Medicine, Internal Medicine, Pediatrics, Orthopedics, and other clinic-based services.   One of the available positions specifically requires prior Georgia Medicare Pro Fee and Pro Clinic coding experience. We are seeking coders with strong E/M expertise who are comfortable in high-volume production environments and have recent hands-on Pro Fee and Pro Clinic coding experience. At HCCS, coders are assigned based on proven specialty expertise to ensure alignment with providers and chart types where they can perform at their highest level. Our Coding and Scheduling Managers work closely...

A Certified Physician Practice Manager oversees the daily operations, business performance, and staff of a medical practice to ensure high‑quality, efficient, and financially sound patient care. Primary Responsibilities Oversee day‑to‑day clinic operations (scheduling, front desk, billing, medical records, patient flow) Manage and develop staff (hiring, training, performance reviews, staffing schedules) Monitor financial performance (budgeting, revenue cycle, A/R, coding and billing accuracy, cost control) Ensure compliance with laws, accreditation standards, payer requirements, and practice policies Optimize patient experience (access, wait times, communication, service recovery) Implement and improve practice workflows, policies, and quality initiatives Oversee EHR/practice management systems and coordinate with IT/vendors Partner with physicians on strategic planning, service line growth, and marketing/outreach...

A Certified Inpatient and Outpatient Professional Documentation Expert is responsible for ensuring the accuracy, completeness, and compliance of clinical documentation across both inpatient and outpatient settings. They collaborate with physicians, nurses, and other providers to clarify diagnoses, procedures, and treatment plans so that the medical record supports the patient’s severity of illness, risk of mortality, medical necessity, and appropriate reimbursement. Key duties include concurrent and retrospective chart review, generating and tracking provider queries, applying official coding and documentation guidelines, educating clinical staff on best practices, and monitoring documentation quality metrics to support regulatory, audit, and revenue cycle integrity.

The Certified Professional Medical Auditor is responsible for performing comprehensive audits of medical records, coding, and billing to ensure accuracy, compliance with federal and state regulations, and alignment with payer policies. This role helps protect the organization from financial risk, supports accurate reimbursement, and promotes high standards of documentation and clinical integrity. Key Responsibilities Perform prospective and retrospective audits of medical records, coding, and billing across assigned service lines (e.g., outpatient, inpatient, behavioral health, SUD/MH, lab). Verify that documentation supports ICD‑10‑CM, CPT, and HCPCS coding; identify under‑coding, over‑coding, unbundling, and other compliance risks. Review claims for adherence to Medicare/Medicaid, commercial payer, and regulatory guidelines; ensure compliance with NCCI edits and payer‑specific policies. Prepare clear, detailed audit reports summarizing findings,...

Medical Coding Appeals Analyst Anticipated End Date: 2025-12-31 Position Title: Medical Coding Appeals Analyst Job Description: Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law This position is not eligible for employment based sponsorship. Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria....

Medical Biller East Haven, CT Full-Time Job Description: We are seeking a detail-oriented and reliable Full-Time Medical Biller to join our team. The ideal candidate will have a solid understanding of medical billing processes, claims submission, and insurance follow-up. This role requires accuracy, strong communication skills, and the ability to work in a fast-paced environment. Key Responsibilities: Manage and process medical billing for various healthcare services. Prepare and submit insurance claims accurately and in a timely manner. Conduct accounts receivable follow-up with insurance companies and patients. Review and resolve billing discrepancies, denials, and outstanding balances. Maintain current knowledge of billing regulations, insurance guidelines, and compliance standards. Collaborate with internal staff and healthcare providers to ensure proper documentation and coding. Required Skills: Proven experience in...

Position:   Experienced OT/PT/SLP   Medical Biller (Remote W2 employee) Location:   Florida, Maryland, Virginia, or Idaho residents only Start Date:   January 12, 2026 Classification:   Non-Exempt, Hourly Hours:   Up to 40 hours per week Important Details You Must Review Carefully Before Applying: This is a fully remote position but showing as hybrid to attract people in the Florida region You must reside in one of the following states to be considered: Florida, Maryland, Virginia, Idaho You must be aware that the compensation is hourly between $18-$26 per hour. If you are seeking highest compensation - please don't apply. The role does not include traditional benefits. No paid time off, no retirement plan, no traditional benefits. We do offer health benefits via an HRA for full-time employees with up to $400 per month contribution. You must have extensive medical billing experience preferably in Speech Therapy private practice sector. This role...

We are looking for an individual who can perform both roles as a professional and outpatient coder. This is a full-time position in downtown Riverside, CA. 

JOB TITLE: Business Office Manager DEPTARMENT: Business Office GENERAL SUMMARY OF DUTIES: An exempt position. Responsible for managing, directing and supervising the reimbursement/coding activities on all services furnished by the physicians/providers of Alaska Heart Institute. Ensures accurate patient billing and efficient account collection to maximize cash flow. SUPERVISON RECEIVED: Reports to Chief Revenue Officer SUPERVISION EXERCISED: Supervises billing office staff which consists of charge posting, payment posting, Insurance/ Medicare research, collections, patient/insurance refunds and bank deposits. ESSENTIAL FUNCTIONS:   Develops departmental objectives and organizes the work of the department.  Reviews work of billing office personnel. Responsible for managing human resources of the billing department staff.  Hires, orients, evaluates performance goals and objectives, recommends merit increases, promotions, and disciplinary actions for...

CPC Expertise in medical record review to abstract information required to support accurate coding. Ability to identify documentation deficiencies and properly query providers for proper code capture. Expertise in assigning accurate CPT, HCPCS Level II, and ICD-10-CM medical codes for diagnoses and procedures. Proficiency across a wide range of services, including evaluation and management, anesthesia, surgery, radiology, pathology, and medicine. A sound knowledge of medical coding guidelines and regulations including compliance and reimbursement – allowing a CPC to better handle issues such as medical necessity, claims denials, bundling issues, and charge capture. CPB Proven knowledge of how to submit claims compliant with government regulations and private payer policies. Ability to follow up on claim statuses, resolve claim denials, submit appeals, post payments and adjustments, and manage collections. In-depth knowledge of...

Phoenix Behavioral Healthcare, LLC is seeking a highly skilled Executive   Director of Revenue Cycle Management (RCM) to oversee and optimize the full revenue cycle across multiple behavioral health facilities, clinics, laboratories, and E&M service lines. This onsite leadership role manages all aspects of RCM operations—including intake, UR/UM alignment, coding, billing, claims submission, collections, clinical documentation improvement, denial management, appeals, and compliance oversight. Key Responsibilities: Lead, manage, and optimize end-to-end revenue cycle operations for all Phoenix facilities Oversee billing and coding for inpatient, outpatient, lab, and professional services (UB-04 & CMS-1500) Direct UR/UM workflow integration to improve documentation quality and turnaround times Manage and mentor a full RCM support team (billers, coders, auditors, documentation trainers, compliance) Develop standardized...

Professional Coding Provider Educator & Reviewer RWJBarnabas Health Oceanport, NJ Full-Time Day Pay Range: $75,597.00 - $106,780.00 per year Pay Transparency: The above reflects the anticipated annual salary range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. Job Overview: The Professional Coding Provider Educator/Reviewer is responsible for preparing educational materials and delivering instruction to Medical Group physicians, Advance Practice Providers, and staff across all RWJBH medical centers, as directed by the System Professional Provider Education Coding Manager and Coding Leadership. Education may be provided in response to compliance reviews, physician onboarding, proactive training, or coding and regulatory updates. This role also conducts...

University Health is one of the largest employers in San Antonio. We are a nationally recognized teaching hospital and consistently recognized as a leader in advanced treatment options, new technologies and clinical research. Our mission is to improve the good health of the community through high quality compassionate patient care, innovation, education and discovery. We are currently looking for a talented health professional to join our team as a Charge Review Analyst. This is an exciting opportunity to join a company with a reputation for exceptional service and patient care.   The Position : Works under the direct supervision of the Coding and Reimbursement Manager, Health Information Management. Codes inpatient, outpatient surgery and observation visits utilizing the ICD-9-CM and CPT coding classification systems. Assists in the training of new coding technicians when appropriate. Promotes the Health System's guest relations' policy.   Duties:...