9 payment integrity coder jobs found

Evolent Health Care Job Opportunity Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. We seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with the Plans' provider agreements and the National...

Coding Specialist This role will have all responsibilities of coding assistant, coder I and II plus the following: assist with special projects as requested, assists with training other coders as requested, monitors and responds to accounts in the charge router, charge router messages, CRMs, compliance and integrity review requests. Adhere to organizational and internal department policies and procedures to ensure efficient work processes. Reviews complex medical documentation at a highly skilled and proficient level from clinicians, qualified health professionals and hospitals in order to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following official coding guidelines and compliance with federal and insurance regulations utilizing an EMR and/or computer assisted coding software. Serves as subject matter expert in your assigned specialty and actively participate in the coding meetings as a problem...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

Join our team at Sixteenth Street Community Health Centers! We are dedicated to the highest quality health care. JOB RESPONSIBILITIES: Review, abstract, and code clinical data such as diseases, operations, procedures, and therapies into computer system for billing and data collection within the established time frame. Assign appropriate ICD-10, CPT, HCPCS and modifiers to accurately report and support the need for each physician service. Identify physician services provided but not adequately documented in the medical record. Advise coding auditor/educator or Manager of deficiencies. Code and abstract patient care records to provide information for insurance/billing and to establish accurate working indices. Perform void/re-enter of charges and changes to insurance as indicated by the medical record and insurance nuances. Perform follow-up claim duties as required and assigned. Comply with the Sixteenth Street TB Control Plan including PPD testing. Perform...

Coder Inpatient II Operations Location: US: WI: MENOMONEE FALLS at our WOODLAND PRIME 400 facility. Work Type: Full-time. Shift: 1st Job Summary: This is a remote, advanced position functioning under general supervision and utilizing independent decision making. The Coder Inpatient II correctly assigns ICD diagnosis and procedure codes and MS-DRGs for inpatient hospital services at Froedtert Hospital, an academic, Level I Trauma Center. The Coder Inpatient II codes a variety of medical and surgical specialties such as Neurology, Oncology, Urology, Transplant, OB/Newborn, Ortho, Cardiology, and Critical Care which can include complex trauma and acutely ill patients. Coders in this role communicate with care providers, when necessary, mainly via the electronic query process. In order to ensure the most appropriate DRG assignment, coders partner with clinical documentation improvement specialists with the goal of obtaining the most complete and accurate medical record documentation....

Coder Inpatient III, Fch - Him - Operations Job Title: Coder Inpatient III, Fch - Him - Operations Occupational Category: Please choose the most appropriate choice based on the job title and description. Duties and Responsibilities of Job: Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility. This job is remote. FTE: 1.000000 Standard Hours: 40.00 Shift: Shift 1 Shift Details: Holidays: Weekends: Job Summary: This is a remote, high-level position functioning under general supervision and utilizing independent decision making. The Coder III correctly assigns ICD diagnosis and procedure codes, MS-DRGs, and APR-DRGs for inpatient hospital services for Froedtert Health, which includes an academic, Level I Trauma Center. The level III Coder completes coding on highly complex trauma and acutely ill patients, including mortality, extended length of stay, and high dollar cases. This position is differentiated from the Coder II...

Medical Coder Our hospital provides high-quality care that transforms the lives of those living with disabling injuries and illnesses. We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we serve. The Medical Coder reviews and assigns diagnostic and procedure codes to patient records for reimbursement and data purposes, in keeping with state and federal regulations. This position must integrate company values into daily practice. Essential Functions Include: Assigns codes using the International Classification of Disease-10th Revision-Clinical Modification (ICD-10-CM). Ensures codes are accurate and sequenced correctly in accordance with government and insurance regulations. Maintains a 95% threshold for coding accuracy. Receives and reviews patient charts and documents for accuracy. Identifies discrepancies and follows up with the provider on any documentation that is insufficient or unclear. Queries...

Join our team which is committed to the delivery of the highest quality healthcare service. We are seeking a full-time Certified Professional Coder who is self-motivated, energetic, and a take-charge individual. JOB RESPONSIBILITIES: 1. Review, abstract, and code clinical data such as diseases, operations, procedures, and therapies into computer system for billing and data collection within the established time frame 2. Assigns appropriate ICD-9, ICD-10, CPT, HCPCS and modifiers to accurately report and support the need for each physician service 3. Identifies physician services provided, but not adequately documented in the medical record. Advises coding auditor/educator or Manager of deficiencies 4. Codes and abstracts patient care records to provide information for insurance/billing and to establish accurate working indices 5. Perform void/re-enter of charges and changes to insurance as indicated by the medical record and insurance nuances 6. Comply with the...

POSITION ELIGIBLE FOR $2,000 SIGN ON BONUS Discover. Achieve. Succeed. #BeHere Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility. This job is REMOTE. FTE: 1.000000 Standard Hours: 40.00 Shift: Shift 1 Shift Details: Holidays: Weekends: Job Summary: Job Summary: This is a remote, high-level position functioning under general supervision and utilizing independent decision making. The Coder III correctly assigns ICD diagnosis and procedure codes, MS-DRGs, and APR-DRGs for inpatient hospital services for Froedtert Health, which includes an academic, Level I Trauma Center. The level III Coder completes coding on highly complex trauma and acutely ill patients, including mortality, extended length of stay, and high dollar cases. This position is differentiated from the Coder II level by the high complexity and longer lengths of stay. The Coder III will also be required to perform chart audits as needed for Coder Inpatient I's and...