1549 jobs found

Summary This position is responsible for the timely auditing and coding of professional services based on provider documentation, ensuring that all services are in compliance with the Tulane University Medical Group (TUMG) Guidelines. Responsibilities also include maintaining knowledge base relative to billing functions, internal and external regulations and documentation issues. This individual is required to maintain current knowledge of CMS and Louisiana guidelines that govern reimbursement for professional services. This person must be able to work independently and process large quantities of data. The ability to communicate clearly and professionally with providers, department administrators, and the TUMG staff and respond timely and accurately to inquiries are key elements required of the individual in this position. *** This position offers remote opportunities. Required Knowledge, Skills, and Abilities Proficient computer skills and a working...

Responsibilities :  Responsible for assignment of accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic) for outpatient encounters in a US Government facility. Plays a significant role in coding compliance activities. Knowledge and Skill: Excellent computer/communication skills Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient), documentation requirements, familiarity with medications and reimbursement guidelines; and encoder experience. Ability to handle multiple projects and appropriately prioritize tasks to meet deadlines Education/Certifications: RHIT, RHIA, CPC, CCS-P Obtain the required CEU requirements to maintain current and proper certifications Experience:...

JOB DESCRIPTION CLAIM TECHNICIAN / ADMINISTRATION SUPPORT - FULL TIME The Illinois Life & Health Insurance Guaranty Association Claim Technician and Administration Support complements team members in various ways including the investigation of medical, behavioral, and long-term care health claims and death benefit claims.  This position works in conjunction with the claims team and utilizes policies and procedures to perform adjudication, adjustments and audits of claims, ensuring accuracy of payment details.  This position is the point person to ensure that claim benefit payments are distributed properly and includes such assistance as claims intake, TPN issues, document handling and maintenance of electronic folders and processes, including procurement. To be successful as a Claim Technician / Administration Support , candidates should be professional, polite, and attentive while also being accurate. The Claim Technician/ Administration Support should...

Responsibilities include, but are not limited to, the following: Preparing claims for electronic claims submission through a clearinghouse or direct submission to the insurance payer; Preparing paper claims for submissions via mail; attaching medical records when necessary for claim processing; Retrieving correspondence received from the clearinghouse or insurance company via mail and resolving all rejected claims for resubmission; Updating the billing system with necessary corrections for claims submission; Troubleshooting claims submissions; Maintaining a daily log of all uploaded, sent, and rejected claims; Establishing and maintaining a professional relationship with the clearinghouse and all insurance Electronic Data Interchange (EDI) department personnel and co-workers; Working with the Insurance Specialists to ensure proper filing of claims; Operating, using, and maintaining office equipment as trained. Minimum education and professional...

Seeking Breakthrough Makers Children’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation. At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career. CHOP’s Commitment to Diversity, Equity, and Inclusion CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children. We strongly encourage all candidates of diverse...

JOB SUMMARY Conducts risk-based and ad hoc coding compliance audits of inpatient and outpatient professional fee encounters to validate code assignment is in compliance with official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Understands, interprets, and applies coding guidelines for coding audits. Audits inpatient and outpatient professional fee diagnosis, Evaluation and Management, and procedural code assignments. Reviews claims to validate submitted codes and abstracted data including, but not limited to ICD-10 CM codes, CPT codes, and HCPCS codes which impact reimbursement. Creates clear and accurate audit findings and recommendations in written audit reports that will be used for advising and educating Coders, Auditors, Managers, and...

Job Req ID:   111341 Compliance Auditor We are seeking a  Compliance Auditor   who will provide audit and research support to physicians, advanced practice professionals, professional fee billing staff, clinic staff, administrators, and other affected personnel on documentation and billing requirements. Using established auditing and research techniques, determines the adequacy of medical records documentation, coding and billing for all providers across all clinical specialties. Works in close collaboration with the Sr. Auditors/Trainers, Associate Managers, Associate Director and Director to provide input and assist in the development of any applicable training and education content. Assists in the preparation of reports for the Senior Director, Director, and clinical departments regarding the status or results of the reviews. The documentation audits are conducted as part of the School of Medicine’s Professional Fee Compliance Program....

The position can be as an IC  or employee Under the direction of Compliance and Coding Management, the Medical Auditor is responsible for performing focused coding quality reviews to validate the integrity of code assignments by Coding Specialists for E/M levels, CPT procedures, modifiers, HCPCS codes and ICD-10 codes according to medical chart documentation. The Auditor will document and report to management relevant coding and provider documentation trends including areas that are high risk for potential compliance concerns. The Auditor is responsible for offering recommendations for improvement to maintain a minimum of 95% coding quality across the department. The Auditor ensures billing optimization and minimizes errors by identifying opportunities during review and audit. The Auditor will assist with special projects as needed. The Auditor is responsible for maintaining current coding regulatory and procedure changes which may affect coding compliance and reimbursement....

As the Operations Manager, you play a crucial role in ensuring the smooth functioning and efficiency of our organization. Your primary responsibility is to provide leadership to your assigned office and oversee its overall performance. You will work closely with the Director of Operations to drive process improvements, implement changes, and evaluate the success of new initiatives. Your role also involves managing employees in compliance with company policies and regulations, from recruitment and training to performance management and issue resolution. Key Responsibilities: Enhance Organizational Effectiveness: Streamline operational systems, processes, and policies to align with our mission. Improve management reporting, information flow, and organizational planning. Boost Operational Efficiency: Enhance the effectiveness and efficiency of operations in your assigned region. Foster collaboration and communication between support and...

Scope of Duties:  The Appeal Specialist collaborates with the AR and Coding team to ensure the proper and accurate submission of appeals. This includes appeal cover letter creation and improvements, appeal package preparation review, and knowledge of  payer requirements for sending all levels of appeals. The Appeal Specialist provides verbal and written communication to educate the AR and Coding team on the proper protocol for submitting successful appeals. This includes frequent monitoring and tracking of successful and unsuccessful appeals to ensure  BEST-IN-CLASS service to our clients.  Basic knowledge of denials and able to determine root cause and possible trends Ability to research, organize, and maintain knowledge and resource materials for payer requirements/guidelines related to sending all levels of appeals, including medical record submission requirements, and method of sending appeals Continual follow up with payers to keep up to date on...

Scope of Duties:  The Dermatology Auditing Coordinator assists with coding and documentation accuracy in accordance with state, federal, and payer guidelines by engaging in and overseeing internal audits, payer audits, and provider education and training. The role focuses on mitigating coding and documentation errors, engaging in compliant audit process improvement, maintaining and monitoring the client audit program, and employee training and assessment reviews collaborating with remote departments to achieve these goals and objectives. The Dermatology Auditing Coordinator works along with the coding team to provide BEST-IN-CLASS service to our clients.    Read and abstract physician office notes and operative notes to apply correct ICD-10-CM, CPT ® , HCPCS Level II, and modifier coding assignments.  Assist with E/M audits using the 2021 evaluation and management (E/M) guidelines for new and established office and outpatient services, as well as E/M...

Scope of Duties:  The Dermatology Coding Specialist provides guidance in accordance with state, federal, and payer guidelines and is responsible for accurate coding, auditing, and training. The specialist works along with the coding team to provide the BEST-IN-CLASS service to our clients.  Read and abstract physician office notes and operative notes to apply correct ICD-10-CM, CPT ® , HCPCS Level II, and modifier coding assignments.  Work with the AR team to address and provide resolution for coding related denials including appeal cover letter creation and review.  Assist with E/M audits using the 2021 evaluation and management (E/M) guidelines for new and established office and outpatient services, as well as E/M coding based on 1995 and 1997 documentation guidelines. Collaborate with the offshore coding team to perform yearly provider/client audits including ongoing monitoring and education.  Research coding questions and provide...

Compliance Educator (Cert. Professional Coder) Corporate Compliance   Full Time Day Shift  8:00am - 5:00pm, Mon-Fri Consistently named best hospital, Lexington Medical Center dedicates itself to providing quality health services that meet the needs of its communities. Ranked #2 in the state and #1 in the Columbia metro area by U.S. News & World Report, Lexington Medical Center is the only hospital named one of the Best Places to Work in South Carolina. The 607-bed teaching hospital anchors a health care network that includes five community medical centers and employs more than 8,000 health care professionals. The network includes a cardiovascular program recognized by the American College of Cardiology as South Carolina’s first   HeartCARE CenterTM  and an accredited Cancer Center of Excellence affiliated with MUSC Hollings Cancer Center for research and education. The network also features an occupational health center, the largest skilled nursing...

Compliance Data Analyst (Cert. Professional Coder)  Corporate Compliance   Full Time Day Shift  8 - 4:30p, Mon-Fri ****Must be a South Carolina Resident  Consistently named best hospital, Lexington Medical Center dedicates itself to providing quality health services that meet the needs of its communities. Ranked #2 in the state and #1 in the Columbia metro area by U.S. News & World Report, Lexington Medical Center is the only hospital named one of the Best Places to Work in South Carolina. The 607-bed hospital anchors a health care network that includes five community medical centers and employs nearly 8,000 health care professionals. The network includes a cardiovascular program recognized by the American College of Cardiology as South Carolina’s first HeartCARE CenterTM and an accredited Cancer Center of Excellence affiliated with MUSC Hollings Cancer Center for research and education. The network also features an occupational health center, the...

Seeking a certified medical coding professional with the following qualifications: Able to work ON-SITE in Ft Myers physician office or Hobe Sound, Florida medical billing office Has 2+ years of experience in medical coding Has obtained and currently holds either Certified Professional Coder (CPC), Certified Professional Coder-Apprentice (CPC-A), or Certified Risk Coder (CRC). The responsibilities include: Proficient in medical coding (ICD-10/CPT/HCPCS) and billing software (preferably Advanced MD). Reads patient charts/physician notes and creates charge slip  Utilizes ICD-10 CM codes on patient’s medical records for medical coding purposes Reviews patient's records for HEDIS and MRA.  Complies within the standards and procedures of medical coding rules and regulations Performs other duties as assigned, modified, and may be expanded to include other responsibilities at the company’s  discretion Additional things to consider:...

Organization benefits for position: 100% remote but candidate  must reside in California These are full-time opportunities Full Benefits - Health/Dental/Vision/Life/AD&D/FSA Basic Term Life Insurance and accidental death insurance 401(k) contributions  Client to provide Codify Equipment supplied Position – OP Ancillary Physician Coder: CPC or CCS required  CCC or CCVTC preferred Minimum of  3 years of current experience  in a hospital or physicians office as a medical coder Expert knowledge of ICD10-CM, CPT, and HCPCS EPIC software experience  required Proficient with Microsoft Purpose Statement / Position Summary Under the direction of the Manager, Coding Compliance, the OP Ancillary/Physician Coder will play a key role in reviewing and analyzing billing and coding for processing. This role will be responsible...

Title : Charge Posting Associate   Mandate :   To perform and complete all tasks at the highest level of professionalism* and competence* within the scope of authority and responsibility of the overall function.   Responsibilities ·           Charge Posting ·           Administration ·           Professional Development   Objectives (by Responsibility)   Charge Posting   1.     Resolving issues in all vendor work queues/buckets/assignees per client. This would include all new bills and any issues that come back to charge entry from A/R in the denial process.   2.     Resolving scrubber denials that cannot be resolved by Global.   3.     Resolving rejection denials that cannot be resolved by Global.   4.     Resolving On Shore review issues.   5.     Checking for task messages or emails from client and either addressing them or reassigning them appropriately....

About the company Tensor is bringing artificial intelligence (AI) to the RCM industry – to improve patient access to high quality, affordable healthcare. We do this by streamlining and automating the most error-prone and time-consuming parts of revenue cycle management (RCM). We are an early stage, venture-backed startup based in San Francisco, CA. Role This role is a rare opportunity to get in at the ground floor of a company that will revolutionize the RCM industry. The RCM Specialist will work directly with the founders to build the company’s RCM function. Day to day, you will conduct RCM operations for our clients (healthcare providers in dermatology, ENT, ophthalmology, and orthopedics). You will also work alongside the engineering team to design software that supports you by streamlining the most error-prone and time-consuming parts of your day-to-day. The ideal candidate… Has a strong work ethic & wants to work alongside other A-players....

Come join our team at Physician's Data Trust!  Since 2001 Physician's DataTrust (PDT) has been providing state-of-the-art management services to independent physicians.  We specialize in managing physicians with commercial, Medicare Advantaage, Cal MediConnect, Covered California, and Medi-Cal managed care patients.   Job Description: To abstract information and assign ICD-9/10 CM codes from provider documentation and report data using specific software. This position will participate in internal & external record audits as directed and monitor systems and medical records to ensure they are current and provider documentation conforms to regulatory and procedural requirements. Coders work remotely but are required to conduct and attend local onsite trainings/audits/chart reviews at provider offices.   Position Responsibilities: ·         Abstract coding information from EMR or handwritten medical charts effectively and efficiently. Provide feedback to...

A typical day will look as such.. -Entering office charges passed over by the provider -Reading and correctly coding OP notes/hospital visits to then manually enter into EPIC -Working any insurance denials and follow ups (I.E sending in medical records, appealing any incorrect denials) -Working with the providers office to answer any questions they may have for us in regards to coding

AAPC Recruiting Services is working on behalf of organization that has provided patients with unmatched quality care.  This is a stable, private practice that offers personal care and focuses on building relationships with all the patients they serve.  If you are detailed oriented, looking for a fantastic work culture, and like to be flexible...then read on! Currently, they are seeking a certified medical billing professional with the following qualifications: Able to work ON-SITE in the West Palm Beach (Florida) area Has 2+ years of experience in medical coding Has obtained and currently holds either Certified Professional Coder (CPC), Certified Risk Coder (CRC), and/or the Certified Professional Biller (CPB) The responsibilities include: Updates patient data, developing payment plans, and preparing invoices Ensures that patients are billed quickly and accurately  Processes insurance claims, denials, and verifications within the...

AAPC is seeking a highly motivated and dedicated coding professional to join our team as a Contract Coder. This position is a fully remote contract role. The ideal candidate must have at least 5 years of coding experience for physician practices, with various surgical specialties as well as E/M. The position requires one to be resourceful, organized, and extremely driven. The ideal candidate will possess the following: Minimum 5 years of coding experience Extensive coding in multiple specialties including: all primary care specialties, anesthesia, general surgery, dermatology, and orthopedics. Excellent written and verbal communication skills Detail oriented and deadline driven attitude Sound knowledge of medical terminology Strong computer skills (Excel, Word, and internet) Ability to multitask and keep a sense of urgency Excellent customer service skills Strong time management, organization skills, and work ethic Job Duties:...

Looking for a Subcontractor Medical Coding Opportunity?   We have 5 remote contract opportunities working with the Veterans Health Administration- Veterans Affairs:   -        Outpatient Medical Coder -        Inpatient Medical Coder -        Surgery Coders -        Pro Fee Coders -        Auditors   Key Skills and Experience:   -        Required 2 years’ experience in the Veterans Health Administration- Veterans Affairs as a Medical Coder -        Active credential/certification with AAPC or AHIMA   If you meet these qualifications and are looking for part-time work, we want to speak with you and tell you about this great opportunity!

JOB SUMMARY: Hours: Monday - Friday 7am-5pm (Flexible) - Transitioning to hybrid soon  Location: North Phoenix. 1929 W Lone Cactus Dr., Phoenix, AZ 85027  The Eligibility Billing Specialist provides comprehensive advanced billing support to Pathology Billing Services, LLC to enhance the generation of accurate billing of insurance claims and patient statements. All employees are responsible for supporting the company’s goals and mission by following all company policies and procedures.   ESSENTIAL FUNCTIONS: Work assigned client workload in a timely manner. Review and resolve any front-end eligibility edits for clean claim submission(s) (i.e., patient demographics, insurance, etc.) Ability to research and obtain specific insurance plan information such as payor address, clearinghouse data and other field requirements. Maintains productivity and accuracy metrics per department expectations. Complete status...