3726 coder professional jobs found

Anesthesia/Pain Coder Professional Fee Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. The posted compensation range of $26.26 - $44.56 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law. This is a senior level professional fee coding position with at least three (3) or more years of recent experience in anesthesia and pain coding....

Certified Professional Coder - Professional Review Specialist II The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a hybrid role. Training is onsite Full Time, then Hybrid once trained. Essential Functions & Responsibilities: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned Knowledge & Skills: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C...

Medical Coder - Professional Medical Coder-Professional is responsible for reviewing and coding medical records and documentation for healthcare services rendered. This role ensures that all diagnoses, procedures, and services provided are accurately coded using standardized coding systems (ICD-10, CPT, HCPCS). The coder will ensure compliance with insurance requirements, governmental regulations, and industry standards to facilitate correct reimbursement and support the accurate billing process. Education and Experience Required: High school diploma/GED Certifications, Licenses or Registration Required: N/A Preferred Qualifications: Associate's degree in health information management or medical coding and experience in medical coding or healthcare billing. One of the following medical coding certifications from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) is preferred post-hire within one (1) year:...

Coder - Professional Functioning within the health system# mission, values, objectives, procedures and policies, the Coder - Professional codes all physician office medical records as assigned by reviewing the entire medical record to determine if the documentation supports the code assignment as well as reviewing the chart for any specific regulations such as medical necessity. Education: An associate#s degree or completion of a certified coding program is required. Licensure/Certification: Current CPC or AHIMA Certified Physician Coder is required. Will consider candidate who is actively enrolled in certification program. To retain position, if individual without a current certification is hired into a Coder - Professional position, s/he must successfully obtain certification within one year of hire. Experience: A minimum of two years of coding experience in a physician#s office or hospital setting is preferred. Skills: Must be knowledgeable in grouper mechanics,...

Coder - Professional Functioning within the health system’s mission, values, objectives, procedures, and policies, the coder professional codes all physician office medical records as assigned by reviewing the entire medical record to determine if the documentation supports the code assignment as well as reviewing the chart for any specific regulations such as medical necessity. Education: Must be currently enrolled in a medical coding program. Licensure/Certification: Will consider candidates who are actively enrolled in a certification program. To retain position, if an individual without a current certification is hired into a coder professional position, s/he must successfully obtain certification within one year of hire. Experience: Experience in medical office preferred. Skills: Must demonstrate proficiency with reimbursement and MS-DRGs. Basic competency with Word and Excel is also required.

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process. Department: Health Information Management Shift/schedule: Full Time (40 hrs/wk) GENERAL SUMMARY Works under the supervision of the HIM Manager (Operations & Auditing). The primary function of the HIM Coder - Professional is to code and charge medical office visits for professional claims. Must be able to review and edit charges in Meditech as well as review leveling criteria for E/M charging accuracy, charge for procedures and other billable services provided in the clinic/office setting. Must be able to code ICD-10 diagnoses and CPT codes while ensuring they are assigned correctly and sequenced appropriately. Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines. Performs other duties as assigned....

The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a hybrid role. Training is onsite Full Time, then Hybrid once trained. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in Microsoft Office...

Job Title Inspire health. Serve with compassion. Be the difference. Job Summary Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support reporting an...

Inspire health. Serve with compassion. Be the difference. Job Summary Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support reporting an HCC....

Inspire health.Serve with compassion.Be the difference.Job SummaryResponsible for validating/reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings.Adheres to all coding and compliance guidelines.Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s).Communicates with providers and team members regarding coding issues.Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values:Inspire health.Serve with compassion.Be the difference. Validates/reviews codes for assigned provider(s)/Division(s) based on medical record documentation.Adheres to all coding and compliance guidelines. Responsible for resolving all assigned pre-billing edits Communicates billing related issues and participates in meetings to improve overall billing process Provides feedback to providers in order to clarify...

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day. Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn #J-18808-Ljbffr

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day. Job Overview Assigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements, knowledge and expertise in reviewing and adjudicating coding services, procedures, and diagnoses on medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT codes into the NextGen system. Minimum Requirements A...

## Certified Professional Coder IApplyremote type: In Personlocations: Commerce, CA 90040time type: Full timeposted on: Posted Todayjob requisition id: JR10049**Grow Healthy**If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.**Job Overview**The Certified Coder I is responsible for reviewing medical documentation and assigning accurate ICD-10-CM, CPT, HCPCS, and applicable modifier codes to support compliant billing,...

Job Description Job Description Description: Position Overview The Professional Billing Coder – Vascular Surgery is responsible for accurate coding of professional services related to vascular procedures. This role supports compliant billing practices and contributes to revenue integrity and audit readiness. Requirements: Key Responsibilities Assign accurate CPT, HCPCS, and ICD-10-CM codes for vascular surgery procedures Review operative and procedural documentation for coding accuracy and completeness Apply appropriate modifiers and NCCI edits • Ensure adherence to CMS, AMA, and payer guidelines Maintain accuracy and productivity standards in a high-volume environment Support internal audits and quality improvement initiatives Required Qualifications Minimum 2+ years of professional billing coding experience Proven experience with vascular surgery coding Strong knowledge of CPT, ICD-10-CM, modifiers, and NCCI edits CPC or equivalent certification...

Job Description Job Description Description: The Professional Fee (ProFee) Coder is responsible for reviewing provider documentation and assigning accurate CPT, HCPCS, and ICD-10-CM codes for physician services. This role supports compliant coding, accurate charge capture, and overall revenue integrity across a variety of specialties and client environments. Coders may support single-specialty or multi-specialty engagements depending on client needs and experience. Requirements: Core Responsibilities (Sage Standards) Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes Ensure documentation supports coded services and identify discrepancies Apply appropriate modifiers, NCCI edits, and payer-specific coding rules Ensure compliance with CMS, AMA, and payer guidelines Maintain =95% coding accuracy and meet established productivity standards Identify documentation gaps and escalate for clarification when needed Participate in quality...

Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future – we provide the venue for individuals who have the desire and...

Shawnee Health - Certified Professional Coder Join Southern Illinois' leading healthcare organization, with over 360 team members who believe that in taking care of each other and our patients and clients, we create new opportunities for success and bring big dreams to life. Shawnee Health is seeking a Certified Professional Coder for our Shawnee Health Remote Billing office. This position reports directly to the Assistant Revenue Cycle Manager. Responsibilities • Completes coding and posting of charges for all provider specialties and payer types utilizing the patient encounter information as directed by physicians and medical records notes. • Completes coding and posting for all hospital related visits and surgeries. • Have a comprehensive understanding of coding rules and regulations by CMS, AMA, ADA and Medicaid. • Conducts coding audits and reports feedback back to clinicians for educational and compliance purposes. Requirements • High School Diploma • Certified...

Job Opportunity At Vitruvian Health At Vitruvian Health, we serve with compassion. As the leading healthcare system for northwest Georgia and southeast Tennessee, we are committed not only to strengthening the health of our communities, but also to supporting the growth, success, and well-being of every team member. Formerly Hamilton Health Care System, Vitruvian Health is built on a legacy of trust, innovation, and exceptional care. With more than 80 access points across the regionincluding Hamilton Medical Center and Bradley Medical Centeryou'll have the opportunity to be part of something bigger: a connected, mission-driven team making a difference every day. Our core valuesProfessionalism, Respect, Integrity, Diversity, and Excellence (PRIDE)guide every interaction and decision. We believe in empowering our people, celebrating what makes us unique, and delivering care that reflects the heart of our mission. Join us and build a meaningful career where you're valued,...

Description ENT Specialties, P.C. is a privately owned practice that has been providing comprehensive ENT services to all ages since 1991. As the largest Otolaryngology practice in Lincoln, we have a dedicated group of physicians, physician assistants, audiologists, nurses and staff that excel in providing the highest quality care with a compassionate touch. Position Overview The Certified Coder is a vital member of our team, responsible for accurately translating medical documentation into standardized codes for diagnoses, procedures, and services rendered. This role is particularly focused on coding activities within clinic and Ambulatory Surgery Center (ASC) settings. The Certified Coder ensures compliance with current coding guidelines/regulations and aids in the resolution of claim denials. The ideal candidate is an experienced professional with a keen eye for detail, a firm grasp of surgical coding guidelines, and a commitment to continuous learning and improvement. Key...

Job Overview We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVSHealth®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Responsibilities Determine correct coding and appropriate documentation during the review of medical records. Ensure that state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a comprehensive medical record audit...

Overview Under general supervision, a Certified Professional Coder is responsible for correctly coding professional healthcare claims in order to obtain reimbursement from private insurance companies and government healthcare programs. This is NOT a remote position. Responsibilities May include any and/or all of the following: Accurately enter patient information into LifeLinc’s billing software. Verify patient insurance is valid and active. Organize files and collect data to be entered. Analyze and verify data for errors. Report problems with data received or missing data. Follow-up on data that has not been received. Keep sensitive patient and company information confidential. Appropriately compose and type routine correspondence, memos, letters, etc. Performs other duties as assigned. Qualifications EDUCATION and/or EXPERIENCE High school diploma or general education degree (GED) is required Minimum of 1-year related experience, training, and/or equivalent...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Summary This position is accountable for accurately reviewing, interpreting, auditing, coding, and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment, and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities Understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations. Identify, compile, and code member/patient data using ICD-9/ICD-10-CM and other standard classification coding systems. Support the...