105 certified coder jobs found

AGS Health is seeking an Inpatient Coding Specialist who will be responsible for coding all requested inpatient medical records using the most accurate and appropriate ICD-10-CM/PCS and DRG 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 Inpatient records using the most accurate and appropriate ICD-10-CM/PCS and DRG 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 :  Certified through AHIMA or AAPC (CCS, CPC, or CIC) Minimum 2 years inpatient...

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...

Description The Professional Review Nurse provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills and review of medical reports to determine appropriateness of medical care.  Clinical and/or technical expertise is utilized to address the provision of medical care and to identify inappropriate billing practices and errors inclusive of, but not limited to; duplicate billing, unbundling of charges, services not rendered, mathematical and data entry errors, undocumented services, reusable instrumentation, unused services and supplies, unrelated and/or separated charges, quantity and time increment discrepancies, inconsistencies with  diagnosis, treatment frequency and duration of care, DRG validation, service/treatment vs. scope of discipline, use of appropriate billing protocols, etc.  KNOWLEDGE & SKILLS: Concise and effective verbal and written communication skills  Ability to interface with claims...