2086 jobs found

The Coding Manager will have direct oversight and responsibility of all coding activities. This position manages and oversees daily coding operations and requires expertise in CPT, HCPCS, and ICD-10 guidelines for orthopedics and ambulatory surgery centers.  The Coding Manager will have responsibility to oversee all coding activities in compliance with a pplicable laws, regulations, standards, internal policies and procedures and the Code of Business Conduct and Ethics (“Code of Conduct”).  The Coding Manager works collaboratively with members of other departments and leadership to ensure organizational goals are met. RESPONSIBILITIES Oversight of coding specialists. Assigns CPT, HCPCS, and ICD-10 guidelines in accordance with authoritative coding standards and guidelines. Review and resolve coding denials. Implement policies and procedures to promote accurate and compliant coding and reduce coding denials. Monitor and update payer specific coding...

The Clinical Documentation Improvement (CDI) Manager will have direct oversight and responsibility of all CDI activities. This position manages and oversees daily CDI operations and requires expertise in clinical documentation and coding guidelines for orthopedics and ambulatory surgery centers.  The CDI Manager will have responsibility to oversee all coding activities in compliance with a pplicable laws, regulations, standards, internal policies and procedures and the Code of Business Conduct and Ethics (“Code of Conduct”).  The CDI Manager works collaboratively with members of other departments and leadership to ensure organizational goals are met. Responsibilities: Oversight of CDI specialists. Conduct clinical documentation audits using standardized tools. Collect, maintain, and trend CDI audit results. Implement policies and procedures to promote accurate and complete clinical documentation. Develop and deliver CDI education and training to...

The Director of HIM will have direct oversight and responsibility of coding, medical records, and documentation improvement.  The Director of HIM is responsible for data quality and integrity and ensuring compliance with a pplicable laws, regulations, standards, internal policies and procedures and the Code of Business Conduct and Ethics (“Code of Conduct”).  The Director of HIM works collaboratively with members of other departments and leadership to ensure organizational goals are met. Responsibilities include: Oversight of medical record documentation and coding. Collaborates with other departments and senior leadership to ensure ongoing alignment of priorities and drives measurable improvement across the HIM service line. Provides HIM expertise and direction to division leadership regarding department development, clinical integration, and operational excellence. Provide training to clinical, coding, and administrative staff on medical record...

We are seeking a full time on-site biller/coder to help support our team.  We are a fast paced multi-specialty billing office and the job requires you to perform a variety of billing tasks, including: Verifying eligibility with Medicare, Medi-cal, Commercial and HMO insurances. Posting charges and payments Making insurance claims inquiries and drafting appeals on denied claims  Answering patient phone calls, reviewing accounts, and collecting payments. Please submit your resume for consideration.  

This is a full-time Onsite position located in our Rocky Hill Location. The hours of operation are Monday-Friday, 40 hours a week.  We are looking for a Medical Billing and AR specialist, who is self-motivated with a "can-do" attitude. You will be responsible for following up on unpaid claims, clarifying discrepancies, EFT payment posting and more... Must have at least 2- 4 years' experience. Certification is not required.  You must have a pleasant personality, excellent language skills, and the ability to multi-task.

SCOPE OF WORK: AGS Health is seeking an Profee Interventional Radiology Coding Specialist who will be responsible for coding all requested IVR medical records using the most accurate and appropriate ICD-10-CM, CPT, modifiers, and APC assignment, while meeting specified productivity and accuracy standards. The coding specialist will also be responsible for abstracting key data required from the medical information consistent with UHDDS requirements and other regulatory coding guidelines.     JOBS-TO-BE-DONE ( JTBDs): Codes all requested Profee IVR records using the most accurate and appropriate ICD-10-CM, modifiers, and APC assignment in accordance with coding guidelines. Abstracts, codes, and assigns necessary demographic and clinical data elements required. Writes appropriate, non-leading queries. Maintains quality and productivity according to client requirements. ·           KEY SELECTION CRITERIA: Candidate qualifications :...

The Phia Group is a service-oriented consultant that assists health plans nationwide. We provide our clients with innovative cost-cutting solutions and innovative service offerings. We continue to enjoy growth thanks to our most valuable resource – our talented and committed team. The Reimbursement Specialist plays a pivotal role within our department, ensuring the effective management and resolution of pre-payment and post-payment claims. This dynamic position requires a detailed-oriented individual with excellent communication skills, who is adept at navigating complex problems and prioritizing tasks based on urgency and client demands. The Reimbursement Specialist is instrumental in liaising with customers and service providers, managing sensitive correspondence, and contributing to the continuous improvement of our claims process. At The Phia Group, whose mission is to provide high quality yet affordable healthcare to American employees and their dependents, you can...

UW Medicine Enterprise Records and Health Information has an outstanding opportunity for INPATIENT and OUTPATIENT CODING EDUCATION ANALYSTS WORK SCHEDULE 100% FTE Mondays - Fridays 100% Remote POSITION HIGHLIGHTS Performs daily activities related to auditing, education and training of one or more content areas ERHI has coding oversight for Serve as an expert in Inpatient coding, respond to general coding questions (ICD, DRG, CPT and HCPCS), engage in the development and/or implementation of audit/monitoring plans, participate in the development and/or delivery of educational and outreach materials, report on unit activities, maintain unit records, monitor regulatory developments, and help develop Coding program policies and procedure DEPARTMENT DESCRIPTION Enterprise Records and Health Information (ERHI) is a Shared Service Department that supports all aspects of the patient medical record from governance, integrity, documentation timeliness, completion, clinical coding,...

Certified Nurse Coder Team Lead We are seeking an experienced individual with a CPC (certified professional coder through AAPC) Registered Nurse with Team lead experience. Salary range is $75,000-$85,000 based on experience and credentials. This is a remote position. PLEASE ONLY APPLY IF YOU ARE AN RN & CPC. MUST HOLD THESE CERTIFICATIONS OR WILL BE AUTOMATICALLY REJECTED. Preferred experience with NJ/NY MVA and Workers Comp cases/fee schedules.   Responsibilities: · Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and or NY-covered insureds in accordance with the NJ and/or NY PIP regulations · Interpret medical documentation to ensure accuracy of billed services IE: CPT, HCPCs codes. Review for unbundled services, modifier usage. Perform crosswalk of billed codes to maximize client savings · Provide support/training to code review team regarding proper coding guidelines, interpretation of medical documentation and proper...

Job Description About us: PayerFusion is a healthcare administrative solutions provider that offers health insurers and self-funded employers throughout the US and worldwide with innovative, cost-effective ways to process medical claims, maintain high customer satisfaction levels, and manage healthcare expenses. The Opportunity: PayerFusion is looking for an experienced Claims Examiner-Claims Processor to join our dynamic team. The successful candidate will help streamline our claims process and improve customer satisfaction. This is a great opportunity for an individual who enjoys working in a fast-paced, team-oriented environment. Job Responsibilities: Analyze and process claims in accordance with our clients’ policies and procedures. Identify and investigate inconsistent or fraudulent claims. Liaise with healthcare providers and policyholders regarding claims processing issues. Perform regular quality audits on completed claims. Document claim process and...

Are you an experienced leader in medical coding and revenue cycle operations? We are seeking a Health Information Management Director (working title: Director Professional Coding & Revenue) to oversee a team of over 140 professional coders supporting the clinical activities of University Physicians. This is an opportunity to drive efficiency, ensure compliance, and lead process improvements in a dynamic and ever-evolving healthcare environment. Why Join Us? ✔ Lead and mentor a team of coding managers and supervisors ✔ Play a key role in revenue cycle optimization and compliance ✔ Develop and enhance training materials for providers and coding staff Top Responsibilities 🔹 Oversee coding operations and ensure teams are working efficiently 🔹 Monitor workflows, schedules, and staffing for optimal performance 🔹 Collaborate with Compliance to establish and enforce policies and procedures 🔹 Identify process improvement opportunities and implement strategic solutions...

AllSpine Pain and Wellness, located in Staten Island, NY, is seeking a highly organized and experienced Out-of-Network (OON) Biller/Collections Specialist to join our growing team. A new location in New Jersey will be opening shortly, and travel between the locations may be required. This role will focus on billing for pain management, vein treatments, anesthesia, and spine procedures. The ideal candidate will be familiar with No Surprises Act (NSA) billing, the IDR (Independent Dispute Resolution) process, and have extensive experience with New Jersey and New York PIP (Personal Injury Protection) and WC (Workers' Compensation) billing practices. You should possess strong attention to detail, exceptional problem-solving skills, and a proactive approach to ensuring timely reimbursement for services rendered. Key Responsibilities: OON Billing & Collections: Manage the full spectrum of OON billing, including submission, follow-up, and collections, for services provided...

Sierra7 is hiring both inpatient and outpatient medical coders to assist the Department of Veterans Affairs. This position is variable up to 25 hours per week.   - We offer great perks to medical coding employees too! Sierra7 offers professional certification reimbursement and 401K eligibility. Don’t miss out on this opportunity! - To Be eligible for this position you must have at least 1 year of experience coding for the Department of Veterans Affairs.  - Must have a minimum of two years’ experience in inpatient or outpatient coding Job Requirements: Must be credentialed and have completed an accredited program for coding certification or health information management/health information technician program. Certification from AHIMA (RHIA, RHIT, CCS, CCS-P) or AAPC (CPC, CPC-H) is required. Minimum of two years’ experience in inpatient or outpatient coding. At least one year of experience coding for the Department of Veterans Affairs. Make a...

Job Summary Remote Medical Billing Specialists provide best-in-class billing services to our private pediatric practice clients. Review claims for accuracy; oversee processing of claims to payers; resolve insurance company payments that are late, underpaid or denied; work closely with providers, practice managers and staff to implement best practice protocols. Responsibilities Learn and become proficient with the premiere pediatric system in the industry- Physician’s Computer Company (PCC) Billing. Efficiently analyze insurance claims throughout the submission process, insuring claims are accurately coded in a timely fashion, and for optimum reimbursement and compliance. Ensure that all claims reach the payers, and independently resolve any issues (underpayments, denials, etc.) with the claims so they are paid fully and on time. Post payments, organize processing of patient correspondence and statements. Answer phone inquiries from patients regarding...

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 motivated Coding Education Specialist with an emphasis in Adult Inpatient experience to join our Coding Services department.    This job can be performed 100% remotely and out of state candidates will be considered. The Coding Education Specialist will primarily be responsible for supporting and leading ongoing education to existing coding staff,...

The University Eye Center ( UEC ) of the State University of New York College of Optometry, an Article 28 Diagnostic and Treatment Center, is seeking a Certified Professional Coder. The successful candidate must be detailed oriented and be able to multitask with excellent time management, problem solving and investigative skills. Understanding of managed care, Medicare, Medicaid, commercial payers and self-pay guidelines is required. Reporting to the Director of Patient Financial Services, the Certified Professional Coder will be responsible for the review of pre and post charges in order to maximize reimbursement, minimize denials and comply with accepted coding practices. Responsibilities/Job Functions: Review provider documentation for charge accuracy and correction of diagnostic and procedural coding, coding integrity and revenue optimization prior to claims submission. Reviews and monitors statistics and key performance indicators to identify improvement...

INSPIRING HEALTHY LIVES through community   At Natividad, our dedication to the people of Monterey County is at the heart of everything we do—from the health care services we provide to the specialized programs we promote. This commitment to our community spans more than 130 years and, more importantly, has touched countless lives. It has also earned us a Joint Commission ranking in the top percentile of hospitals nationwide. If you believe in inspiring healthy lives by focusing on community-based care, consider joining Natividad today.   TRAUMA REGISTRAR   Natividad may offer up to a $10,000.00 sign-on bonus to candidates hired into permanent, full-time positions.   Natividad is currently seeking two permanent, full-time Trauma Registrars in the Trauma Services Department. Under general supervision, successful candidates will identify, collect and abstract data for the trauma registry, National Trauma Data Bank (NTDB), Trauma...

MISSION Through a collaborative and positive approach, the Compliance Specialist/Auditor will promote ongoing organizational compliance, revenue integrity, and efforts to provide efficient and effective services to patients. Using the results of audit/monitoring activities, this role will improve identification of opportunities to mitigate risks of potential non-compliance with regulations, policy, and industry standards, while facilitating process improvement. OUTCOMES Perform regular and ad hoc reviews of key organizational risks (e.g. policies, processes, clinical documentation, statutory and regulatory changes) to promote ongoing organizational accuracy, compliance, and risk mitigation. Provide individualized and actionable feedback based on audit results. Develop appropriate educational and resource materials. Assist with audit & compliance   related special projects as requested . Use strong written, verbal, and “people”...

Lead a team of 8 reports in a busy women's healthcare practice.  Friendly practice culture, excellent benefits and very competitive salary. This position is for management level candidates only and would report directly to the Chief of Operations and Chief Executive Officer

Medical Coding Auditor Are you passionate about making a difference in the health of rural communities? Community Health of Central Washington has an opening for a Medical Coding Auditor to train new and existing Providers on accurate coding. You will be responsible for reviewing and auditing medical coding for accuracy, compliance and completeness to ensure adherence to coding standards, guidelines and regulatory requirements. Qualifications: ·       HS Diploma or equivalent and 3 years of medical coding experience is required ·       Associate or Bachelor degree in related field is preferred ·       Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Inpatient Coder (CIC) is required ·       Certified Professional Medical Auditor (CPMA) with prior auditing experience is highly desirable ·       Valid Driver’s license and auto insurance is required Immunizations are required prior to start...

Hello! Are you passionate about helping businesses streamline their insurance verification processes? Do you find it rewarding to accurately verify coverage and resolve eligibility issues? If you enjoy tackling unique challenges and using your problem-solving and analytical skills, we have the perfect opportunity for you! Join pMD as a flexible contract specialist, where you can enjoy: Complete Flexibility : No minimum working hours or daily requirements. Work as much or as little as you want! First Come, First Serve : Secure work on your schedule, based on availability. Meet Your Goals : Balance your workload to meet your compensation targets. Take control of your work-life balance and make a meaningful impact in the world of medical billing. Ready to jump in? We are currently only accepting applications through our website . Please click the application link below if you'd like to be considered. (Contract) Medical Insurance Verification Specialist...

Hello! Are you passionate about helping businesses clean up their old claims? Do you find it rewarding to efficiently resolve billing issues? If you love tackling unique challenges and using your problem-solving and analytical skills, we have the perfect opportunity for you! Join pMD as a flexible contract specialist, where you can enjoy: Complete Flexibility : No minimum working hours or daily requirements. Work as much or as little as you want! First Come, First Serve : Secure work on your schedule, based on availability. Meet Your Goals : Balance your workload to meet your compensation targets. Take control of your work-life balance and make a meaningful impact in the world of medical billing. Ready to jump in? We are currently only accepting applications through our website . Please click the application link below if you'd like to be considered. (Contract) Medical Claims Resolution Specialist The (Contract) Medical Claims Resolution...

Hello! Are you passionate about helping businesses clean up their old claims? Do you find it rewarding to efficiently resolve billing issues? If you love tackling unique challenges and using your problem-solving and analytical skills, we have the perfect opportunity for you! Join pMD as a flexible contract specialist, where you can enjoy: Complete Flexibility : No minimum working hours or daily requirements. Work as much or as little as you want! First Come, First Serve : Secure work on your schedule, based on availability. Meet Your Goals : Balance your workload to meet your compensation targets. Take control of your work-life balance and make a meaningful impact in the world of medical billing. Ready to jump in? We are currently only accepting applications through our website. Please click the application link below if you'd like to be considered. (Contract) Credentialing Specialist: (Contract) The Credentialing Specialist Contractor role at...

The State University of New York College of Optometry seeks a skilled Medical Billing Specialist to work in our Patient Financial Services department. This position is onsite at 33 West 42nd Street New York, NY 10036 Responsibilities /Job Functions: • Reviews and analyzes “Explanation of Benefits” (EOBs), payer correspondences to identify denials. • Resolve issues with pending, rejected, or underpaid claims. • Review and resolve uncollected accounts by contacting patients regarding outstanding balances and setting up payment options. • Communicate denial trends/issues to management. • Perform daily tasks in assigned work queues. • Clearly document actions taken on accounts. • Perform other duties as assigned. Requirements: • Experience in denial management required. • A minimum of 3 years billing experience is required, optometry preferred. • Knowledge of Nextgen electronic billing system preferred. • Ability to review and troubleshoot edits through insurance portals and clearing...