63 certified professional coder jobs found

City / State Norfolk, VA Work Shift First (Days) Overview :Sentara Health Plan is currently hiring an Associate Fraud and Abuse Investigator / Certified Professional Coder (CPC) Remote! Status :Full-time, permanent position (40 hours) Work hours :8am to 5pm EST, M-F Location :This position is remote for candidates that live in the following states :VA, NC, AL, DE, FL, GA, ID, IN, KS, LA, ME, MD, MN, NE, NV, NH, ND, OH, OK, PA, SC, SD, TN, TX, UT, WA, WV, WI, WY! With travel to Virginia Beach 1x a year.Job Responsibilities :Responsible for contributing to in-depth investigations for suspected fraud or abuse with respect to provider, pharmacy, employer, member, and broker interactions involving the full range of products.Responsible for contributing to the review of the quality of pharmacy, physician, ancillary and hospital based coding in routine desk audits as well as occasional on-site audits.Contribute to the review of reimbursement systems relating to health insurance claims...

Job Summary :Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, other regulatory agencies, third party payers and Kaiser Permanente policy.Function includes, but is not limited to working charge review work queues, other forms of charge submissions and querying providers to ensure the completeness and accuracy of coding of internal services performed.Essential Responsibilities :Responsible for reviewing primarily medical and ancillary type workques charge sessions within KP Health connect and applying coding principles for correct coding.Research, code, and / or data enter encounters that are supported by KPHC with the Charge capture tool.Review all other charge sessions submitted via paper encounters, physician in baskets and other various methods to ensure correct coding principles have been applied.Query providers for clarification of incomplete or...

Job Summary :Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, other regulatory agencies, third party payers and Kaiser Permanente policy.Function includes, but is not limited to working charge review work queues, other forms of charge submissions and querying providers to ensure the completeness and accuracy of coding of internal services performed.Essential Responsibilities :Responsible for reviewing primarily medical and ancillary type workques charge sessions within KP Health connect and applying coding principles for correct coding.Research, code, and / or data enter encounters that are supported by KPHC with the Charge capture tool.Review all other charge sessions submitted via paper encounters, physician in baskets and other various methods to ensure correct coding principles have been applied.Query providers for clarification of incomplete or...

Job DescriptionJob DescriptionPerforms functions such as reviewing documentation and selecting the appropriate procedure and / or diagnosis code to be entered in billing documents.Insures that teaching physician requirements are met and are clearly reflected in the documentation; and other duties as assigned.EDUCATION and / or EXPERIENCEHigh school diploma or general education degree (GED) preferredCertified Professional Coder certification requiredLevel and years of experience based on departmental needsExtensive knowledge of CPT and ICD-10 codingKnowledge of government regulations as they relate to teaching physiciandocumentation and billing guidelinesUnderstanding of :the importance of compliance with all government, department, and contractual regulations regarding coding and billing; and provider requirementsTotal RewardsThe referenced base salary range represents the low and high end of University of Maryland's Faculty Physician's Inc.salary range for this position.Some...

Reports to the Manager, Coding & Records.Reviews, codes, and analyzes medical records in order to abstract relevant data from patient medical records into the on-line computer system.Assigns DRGs to Medicare, Medicaid, and other required payors.Determines DRG and APC assignment on outpatient and inpatient records.Maintains productivity and accuracy levels for the assigned job code.This is a remote position; however, candidates must reside in one of the following states:Indiana, Michigan, Illinois, Kansas, Ohio, Georgia, Kentucky, Florida, Idaho, Minnesota, Tennessee, Wisconsin, Colorado, South Carolina, North Carolina, or Texas.MISSION, VALUES and SERVICE GOALS MISSION:We deliver outstanding care, inspire health, and connect with heart.VALUES:Trust.Respect.Integrity.Compassion.SERVICE GOALS:Personally connect.Keep everyone informed.Be on their team.Reviews and analyzes discharged patient medical records to ensure all applicable patient data is available for coding and...

Hello, Thank you for your interest in career opportunities with the University of Mississippi Medical Center.Please review the following instructions prior to submitting your job application:Provide all of your employment history, education, and licenses/certifications/registrations.You will be unable to modify your application after you have submitted it.You must meet all of the job requirements at the time of submitting the application.You can only apply one time to a job requisition.Once you start the application process you cannot save your work.Please ensure you have all required attachment(s) available to complete your application before you begin the process.Applications must be submitted prior to the close of the recruitment.Once recruitment has closed, applications will no longer be accepted.After you apply, we will review your qualifications and contact you if your application is among the most highly qualified.Due to the large volume of applications, we are unable to...

ResponsibilitiesThe Coder II reviews, analyzes, and codes diagnostic and procedural information using ICD-10-CM diagnosis and procedures and CPT coding for reimbursement.Assign and sequence ICD-10-CM / CPT codes by applying regulatory coding guidelines.Apply advanced knowledge of disease processes to assign codes for conditions and procedures not listed in the indexes of coding books.Follow appropriate guidelines and policies to code accurately from physician documentation within the medical record.Queries physicians for diagnoses or missing / ambiguous information for accurate coding.Apply organizational documentation policies and procedures in conjunction with official coding guidelines.Applies knowledge of coding and DRG assignment for ethical and optimal reimbursement.Competent to accurately code and abstract all inpatient, 23-hour observations, same day surgery, emergency room and / or clinic records in a consistent, accurate and timely manner.Ensures the final diagnosis...

Job DescriptionJob DescriptionMedical Records Coder / Certified - Full Time (PARTIAL REMOTE / IN OFFICE FOR MTGS)POSITION SUMMARY :Codes medical records using diagnostic coding.Ensures accurate submission of all coding data for reimbursement purposes.Ensures Regulatory Compliance and follows all Federal regulations for all payment systems.POSITION REQUIREMENTS :Minimum EducationHigh School Diploma or equivalentCertificate Required :One of the following Coding Certifications :CCS-Certified Coding SpecialistCPC-Certified Professional CoderCPC-H-Certified Professional Coder-HospitalCOC-Certified Outpatient CoderCIC-Certified Inpatient CoderCMC-Certified Medical CoderMinimum Work ExperienceAbility to read and communicate in English; Bilingual preferredGood communication and multi-tasking skillsMinimum of 2 years' experience with ICD-10 and CPT / HCPCS coding in an acute facility and / or physician's office preferredKnowledge of computer applications for codingKnowledge of medical...

Job DescriptionJob DescriptionSUMMARYThe Certified Risk Adjustment Coder is responsible for accurately abstracting provider services into ICD-10 codes from medical documentation.This role adheres to the coding ethics of organizations such as the American Academy of Procedural Coders (AAPC), American Health Information Management Association (AHIMA), and the National Alliance of Medical Auditing Specialists (NAMAS), as well as payer guidelines.The coder conducts concurrent, prospective, and retrospective reviews of medical record documentation to ensure the accurate and complete capture of the clinical picture, severity of illness, and complexity of patients.Additional duties include provider communication and education to support the closure of both risk adjustment and quality care gaps, as well as providing ongoing feedback to physicians regarding coding guidelines and requirements.ESSENTIAL JOB FUNCTIONSPerform coding quality audits of medical records to ensure ICD-10 codes are...

Reviews claims in assigned work queues in Cerner Revenue Cycle including CMG Review and Ambulatory Edit failure work items.Analyzes coding edits, reviews timeline notes, reviews clinical documentation, including provider orders, progress notes, surgical and test results thoroughly to interpret and ensure documentation supports the posted charges.Determines appropriate action needed to resolve coding edits / issues and ensure clean claim submission.Performs coding functions, including Current Procedure Terminology (CPT), International Classification of Diseases, tenth revision, Clinical Modification (ICD-10-CM), documentation review, and claim denial review.Applies appropriate modifiers.Ensures charges / coding are in alignment with the American Medical Association (AMA),Medicare, and Commercial coding guidelines on all claims reviewed.Credits / updates charges and coding as needed.Ensures queues are worked timely and efficiently.Maintains Productivity and accuracy...

Description:Evaluates health record documentation and charges to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the outpatient visit.Ensures that data complies with regulatory and coding guidelines.Reviews medical information, such as diseases or symptoms and diagnostic descriptions and procedures for a given visit, to accurately assign and sequence the correct ICD-1 CM, HCPCS and CPT codes.Adheres to the quality and productivity standards set by the department.Education Qualifications :Successful completion or currently enrolled in a medical coding program which includes completed course work inICD-1-CM, HCPCS, CPT codes, medical terminology, anatomy and physiology and disease process AND a passing score on the ESSENTIA HEALTH coding skills assessment test.OR Credentialed as, or eligible for, Certified Coding Specialist (CCS), Certified Coding Specialist-Physician Based (CCS-P), Certified Professional...

Join to apply for the Coder II- Remote / CCS, CCA, RHIT, RHIA role at Baptist Health Care.Location Requirement :Candidates must reside in one of the following states- Florida, Alabama, or Georgia.If offered the position, will be required to come onsite in Pensacola, FL for orientation.Job Description :The Coder II reviews outpatient records and accurately assigns appropriate ICD-10-CM or CPT-4 codes according to established guidelines with 97% accuracy rate, while maintaining coding standards for productivity.This position reviews outpatient records and assigns codes according to outpatient rules.The Coder II may be responsible for ER Facility Charging, if applicable.This position follows up on outstanding unbilled accounts on a regular basis and does not have excessive re-bills.Reviews patient medical records and accurately assigns appropriate ICD-10-CM or CPT-4 codes according to established guidelines.Applies sequencing guidelines to coded data according to official coding...

DEFINITION / PRIMARY FUNCTIONThe Senior Coder / Abstractor (remote) codes inpatient records and / or outpatient records using commonly accepted classificationsystems and abstracts the information into the coding software or EMR abstracting.POSITION QUALIFICATIONS (Minimum qualifications are required unless stated otherwise.)Experience :Two years of experience in coding with ICD-10-CM, ICD-10-PCS required.Experience in outpatient coding, or willingness to learn outpatient coding including CPT-4 and HCPCS required.Experience using coding software and EMR required.Previous coding in a teaching facility preferred.Education and Training :High School Graduate, advance education in medical terminology, anatomy and physiology, and pathophysiology are all required.Completion of a medical coding program required.License, Certification & Registration :CCSHRR - Certified Professional Coder-Hospital.Other Requirements :Ability to code all inpatient record types i.e.med / surg, behavioral...

POSITION DESCRIPTION :The Compliance Auditor / Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services.Provides professional expertise and education in CPT, ICD and HCC coding.The Compliance Auditor / Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations.This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution.Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance.ESSENTIAL JOB FUNCTIONS :Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies...

DepartmentFPG Central Billing OfficeJob SummaryIdentifies and applies appropriate ICD-10 diagnostic and CPT procedural codes to individual patient health information for claims processing, data retrieval and analysis.Responsible for patient financial related activities, which includes accurate entry of insurance benefits, authorizations and other activities which ensures complete and accurate claims.Please review :Must be FL resident to work for Sarasota Memorial Health Care SystemMust be able to do onboarding, orientation, and training on-site as needed.Required QualificationsRequire a minimum of two (2) years of experience in a physician office.Require a minimum of one (1) year of CPT and ICD physician coding experience.Require Certified Professional Coder (CPC) or Certified Coding Specialist - Physician-based (CCS-P), or Certified General Surgery Coder (CGSC), or become certified within one (1) year of employment.Preferred QualificationsPrefer a college degree.Prefer...

DepartmentFPG Central Billing Office Job SummaryIdentifies and applies appropriate ICD-10 diagnostic and CPT procedural codes to individual patient health information for claims processing, data retrieval and analysis.Responsible for patient financial related activities, which includes accurate entry of insurance benefits, authorizations and other activities which ensures complete and accurate claims. Remote position - must be able to do pre-employment onboarding, orientation and any additional training on-site as needed. Must be FL resident.Required Qualifications- Require a minimum of two (2) years of experience in a physician office.- Require a minimum of one (1) year of CPT and ICD physician coding experience.- Require Certified Professional Coder (CPC) or Certified Coding Specialist - Physician-based (CCS-P), or Certified General Surgery Coder (CGSC), or become certified within one (1) year of employment.Preferred Qualifications- Prefer a college degree.- Prefer demonstrated...

Overview Summary :Review, monitor, and control charge capture and documentation.Provide on-site physician feedback for coding / documentation practices.Assist physicians with documentation and billing compliance guidelines.Responsibilities Responsibilities :Review clinical documentation and code to the highest level of specificity for accurate charge capture stated by physicians or other healthcare providers.Assign and sequence appropriate codes using current procedure, diagnosis, and HCPCS for insurance billing.Accurately follow coding guidelines and legal requirements to ensure compliance with Federal and State guidelines.Communicates with Special Billers and Charge Follow-up Coordinator in answering insurance billing questions.Reviews and corrects charge review edits.Reviews records to ensure proper submission of services prior to billing on selected charges.Maintains compliance standards in accordance with internal compliance policies.Reports compliance issues...

OverviewFTE:1.0Schedule:Monday - Friday, 8:00 AM - 5:00 PMWork Location:Remote - Authorized remote work states - FL, GA, MO, PA, NC, SC, TN and TXJob Summary:Under general supervision, reviews, analyzes, and assigns final diagnoses and procedures as documented by the practicing provider, ensuring compliance with all policies and guidelines.Accurately codes office and hospital procedures to ensure proper reimbursement.Ensures the accurate completion of electronic health records through the assignment of ICD, CDM, HCPCS, and CPT codes.ResponsibilitiesResponsibilities Review clinical documentation and code to the highest level of specificity for accurate charge capture as stated by physicians or other healthcare providers. Assign and sequence appropriate codes using current procedure, diagnosis, and HCPCS standards for insurance billing. Accurately follow coding guidelines and legal requirements to ensure compliance with federal and state regulations. Communicate with Special Billers...

ResponsibilitiesEvaluates coding based on Coding Guidelines.Reviews records for all care settings.Identifies high volume, high risk coding, and reimbursement and quality problems.Responsible for accurate assessment, analysis and summary of findings for coding validation.Provide auditing and feedback that is incorporated into training education programs.This position offers a fully remote work opportunity.Employees in this role must reside in one of the following states to be considered for fully remote positions :Kentucky, Indiana, Missouri, Ohio, Tennessee, Alabama, Virginia, Mississippi, North Carolina, South Carolina or Louisiana.QualificationsRequired :One year coding in healthcare settingOne of :CCA or CCS or CPCDesired :DiplomaCertified Coding Associate OR Certified Coding Specialist OR Certified Professional Coder.

ResponsibilitiesThe Coder II reviews, analyzes, and codes diagnostic and procedural information using ICD-10-CM diagnosis and procedures and CPT coding for reimbursement.Assign and sequence ICD-10-CM / CPT codes by applying regulatory coding guidelines.Apply advanced knowledge of disease processes to assign codes for conditions and procedures not listed in the indexes of coding books.Follow appropriate guidelines and policies to code accurately from physician documentation within the medical record.Queries physicians for diagnoses or missing / ambiguous information for accurate coding.Apply organizational documentation policies and procedures in conjunction with official coding guidelines.Applies knowledge of coding and DRG assignment for ethical and optimal reimbursement.Competent to accurately code and abstract all inpatient, 23-hour observations, same day surgery, emergency room and / or clinic records in a consistent, accurate and timely manner.Ensures the final diagnosis...

All the benefits and perks you need for you and your family :Benefits from Day One Career Development Whole Person Wellbeing Resources Mental Health Resources and SupportOur promise to you :Joining AdventHealth is about being part of something bigger.Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit.AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ.Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team.All while understanding thattogetherwe are even better.Shift:Monday- Friday Full time 8am-5pmJob Location:RemoteThe role you will contribute :Responsible for reviewing accounts for accuracy using the charge capture audit system in compliance with local, federal, and state guidelines, as well as managed care reimbursement practices.This position uses clinical knowledge and...

All the benefits and perks you need for you and your family :Benefits from Day One - Paid Time Off from Day One - Career Development - Whole Person Wellbeing Resources - Mental Health Resources and SupportOur promise to you :Joining AdventHealth is about being part of something bigger.Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit.AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ.Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team.All while understanding thattogetherwe are even better.Schedule :Full TimeThe role you'll contribute :The Coder Analyst I, under general supervision of the Outpatient Coding Supervisor is responsible for Assigning codes to ER and Outpatient ancillary medical records, using ICD-10-CM and CPT codes via the 3m Encoder and Dolbey Computer...

Crossroads Treatment Centers is an equal opportunity employer.We celebrate diversity and are committed to creating an inclusive environment for all employees.Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder.Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery.This comprehensive approach to treatment, the gold standard in care for opioid use disorder, has been shown to prevent more deaths from overdose and lead to long-term recovery.We are committed to bringing critical services to communities across the U.S.to improve access to treatment for over 26,500 patients.Our clinics are all outpatient and office-based, with clinics in Georgia, Kentucky, New Jersey, North and South Carolina, Pennsylvania, Tennessee, Texas, and...