16 coder lll jobs found

In accordance with current federal coding compliance regulations and guidelines, the Coding Compliance Auditor performs 2nd level review of previously coded accounts to ensure appropriate CPT, ICD-10-CM, and HCPCS assignments – and accuracy and completeness of all ICD-10-CM, CPT, and HCPCS codes assigned by professional revenue coders and providers. All assigned codes must be supported by professional documentation contained within the medical record and must be in compliance with federal coding compliance regulations, Official Coding Guidelines, AHA Coding Clinic, and CPT Assistant. The Coding Compliance Auditor will also, provide detailed reports, Excel spreadsheets, coding audit summary analysis, and data analytics Re: coding accuracy rates, compliance rates, denial analytics, etc. Recommend education topics based on audit findings and assist in the continuing education of professional coders and providers. Understands coding/billing computer systems such as Cerner, MediTech,...

Plans, teaches, directs, and supervises all student learning experiences in the classroom, skills lab, and clinical areas, following the curriculum of the school approved by the Accreditation Bureau. This is a faculty position. PERSONAL:Willingness Baker, Billing, Insurance, Medical, Coder, Program Director, Healthcare, Education

Medical BillerWe are seeking an experienced and diligent Medical Biller who wants to make a difference in our community. We want to hear from you if you thrive in a fast-paced, caring, and compassionate environment!The Mission of South-Central Family Health Center is to improve the quality of life for the diverse community of inner-city Los Angeles by providing affordable and comprehensive health care and education in a welcoming and multi-cultural environment. To lead the way in health care in South Los Angeles, as the premier provider and employer of choice offering comprehensive, high quality, affordable, efficient and culturally responsive services.Under the supervision of the Revenue Cycle/Billing Administrator, the Medical Biller I will be responsible for the processing and responding to all patient-related billing and the submission of bills for reimbursement from various programs (i.e. Medi-Cal, CPSP, EAPC, etc.). The ideal candidate will have to perform some of the...

Revolution Medicines is a clinical-stage precision oncology company focused on developing novel targeted therapies to inhibit frontier targets in RAS-addicted cancers. The company's R&D pipeline comprises RAS(ON) Inhibitors designed to suppress diverse oncogenic variants of RAS proteins, and RAS Companion Inhibitors for use in combination treatment strategies. As a new member of the Revolution Medicines team, you will join other outstanding Revolutionaries in a tireless commitment to patients with cancers harboring mutations in the RAS signaling pathway.The Opportunity:Reporting to the Director, Medical Content and Training, the Associate Director Medical Content and Training will be responsible for shaping the Medical Affairs training and content roadmap in alignment with therapeutic area strategies and launch priorities. This role will play a critical role in preparing the team for product launches in oncology, ensuring they are equipped with the necessary knowledge and...

Medical Coding AuditorAt Sprinter Health, our mission is reimagining how people access care by bringing it directly into their homes.Nearly 30% of patients in the U.S.skip preventive or chronic care simply because they can't get to a doctor's office.For many, the ER becomes their first touchpoint with the healthcare systemdriving over $300B in avoidable costs every year.By using the same technologies that power leading marketplace and last-mile platforms, we deliver care where people are, especially those who need it most.So far, we've supported more than 2 million patients across 22 states, completed over 130,000 in-home visits, and maintained a 92 NPS.Our team of clinicians, technologists, and operators have raised over $125M to date from investors like a16z, General Catalyst, GV, and Accel and enjoy multi-year runway.As a Medical Coding Auditor, you will be responsible for conducting routine and focused audits of medical coding to ensure compliance, accuracy, and quality.You'll...

Claims Billing SpecialistThe Specialist is responsible for resolving inquiries related to claims, eligibility, and authorization and working with multiple parties to ensure records are up to date. The Specialist will ensure first-call-resolution standards are followed and will refer and follow-up as per Hoag guidelines. Ensure accuracy, reports issues, and works to resolve. Ensure compliance and regulatory guidelines and health plan requirements are met. Documents actions taken following HIPAA guidelines. May assist in providing customer service, member services, and others in working with providers/billing offices when needed. Assist in identifying and reporting issues working with the management team to help minimize re-work and address front-end process issues. Performs other duties as assigned.May also maintains databases, audit information and works with patients to process patient payment. May follow up with insurance companies on outstanding or unpaid claims, create/send...

Job Summary:Supervises team to review and request primary source information and verifications. Proactively identifies, suggests improvements to, and provides resolution for complex gaps in vendor relationships. Serves as an escalation point of contact for external queries regarding practitioner status. Evaluates applications and supporting highly complex documents. Guides team to conduct improvements to credentialing and privileging processes. Guides and supervises team to evaluate complex practitioner sanctions. Participates in surveys and audits of credentialing entities. Facilitates and implements strategic initiatives cost-effective due process. Identifies and provides leadership to resolve adverse actions/issues. Leads and evaluates audits of data between different departments. Conducts and supervises the facilitation and orientation and training to newly appointed physician leaders. Develops highly complex informational documents. Maintains working relationships with key...

Plans, teaches, directs, and supervises all student learning experiences in the classroom, skills lab, and clinical areas, following the curriculum of the school approved by the Accreditation Bureau. This is a faculty position. PERSONAL:Willingness Biller, Medical, Coder, Instructor, Insurance, Program Director, Healthcare, Education

Medical Billing Coder - Per Diem 20%Under the direction of the Associate Director/Revenue Manager, the Medical Billing Coder aka Professional Fee Coder - Revenue Cycle Analyst will be responsible for front-end billing functions from procedural & diagnosis coding and charge entry to contacting physicians for documentation tracking and updating. Working under direct supervision the incumbent acquires knowledge of revenue cycle coding practices and concepts. Developing proficiency to manage 500 - 1000 code combinations to include Evaluation and Management Services as well as simple to moderately complex testing and procedural code services. The Medical Billing Coder will work to acquire and master all entry-level coding functions including assigning appropriate CPT and Dx codes, associated modifiers, appropriate NCCI edits, resolving coding edits and RFIs as well as basic entry-level revenue cycle duties. Other duties may include assisting other Departments as needed/assigned. As...

Build Your Future with a Trusted Chiropractic Practice! Join a long-standing, reputable chiropractic office where your expertise truly makes a difference. Our client is seeking an experienced Back Office Medical Coder/Biller who can also serve as the friendly and professional face of their practice. This is a full-time, direct hire position offering long-term stability and growth potential. If you're organized, personable, and well-versed in medical coding, billing, and terminology, this could be your ideal next step. Bilingual in Spanish is a plus! Description -First point of contact for in person patients and on the phone -Ability to manage multiple front office duties and back-office duties simultaneously -Schedule future appointments in person and on the phone -Check patients in and out ensuring all insurance and billing information is obtained -Responsible for diagnosis translation and coding correctly for submission to various insurance companies and parties Description...

Effective July 1, 2025, in accordance with the applicable Memorandum of Understanding, the Personal Leave Program 2025 (PLP 2025) was implemented. PLP 2025 requires each full-time employee in Bargaining Unit 19 , and related Excluded, Exempt and Statutory Exempt employees, will have their base salary reduced by 3 percent and will receive 5 hours PLP 2025 leave credits monthly through June 2027. Salaries do not reflect the recent changes. Part-time employees are subject to the same conditions as full-time employees, on a prorated basis equivalent to their time-base. Permanent intermittent employees are subject to the same condition as full-time employees, based on the number of hours worked in the pay period.Please note: Individuals may be eligible to receive a $10,000 one-time recruitment and retention stipend should they meet the eligibility criteria, including but not limited to remaining employed with CCHCS for six months. Additionally, individuals may be eligible to receive a...

Job DescriptionJob DescriptionMUST ATTEND ORIENTATION IN PERSON IN ARCATA, CALIFORNIASUMMARY :The primary function of this position is to review ICD, CPT and HCPCS coding for data and reimbursement.The coding function is a primary source for data and information used in health care today, and promotes quality client care, captures accurate reporting numbers and optimizes reimbursement.The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.Other duties may be assigned.Level IPerforms comprehensive review of the health record, evaluates the record for documentation, consistency, accuracy and correlation of recorded data.Ensures the final diagnosis as stated by the provider is valid, complete and accurately reflects the care and treatment rendered.Consults with provider when conflicting or ambiguous documentation is...

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...

Join Datavant, the leader in health data exchange, and contribute to a mission where every healthcare decision is driven by accurate data.Our extensive platform connects the healthcare ecosystem, providing secure and accessible data that enhances health decisions.We are proud to work with top life sciences companies, government entities, and healthcare providers.As a part of our high-performing, values-focused team, you will help tackle complex healthcare challenges with innovative, technology-driven solutions.At Datavant, we value diverse experiences and backgrounds, and we're seeking experienced and credentialed outpatient coders like you! This fully remote position offers a flexible schedule, allowing you to make a difference in healthcare from the comfort of your own home.Role Overview:Review medical records to accurately code diagnoses and procedures.Sequence codes based on medical record documentation.Assign appropriate discharge dispositions.Abstract and input coded data for...

Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles.We also were awarded the Advisory Board Company's Workplace of the Year.We provide an outstanding benefit package that includes healthcare, paid time off and a 403(b).Join us! Discover why.News & World Report has named us one of America's Best Hospitals.What will you be doing in this role?Under general direction of the Coding Supervisor, (using knowledge of CSMC and Official Coding guidelines, medical terminology, anatomy and physiology, and pathological basis of disease, documented treatment and procedures performed at CSMC and Cedars-Sinai Affiliates and their locations) assigns ICD-10-CM and CPT codes for patients receiving services at CSMC.Accurately assigns all applicable modifiers for all patients to assure optimal reimbursement and the...

The medical biller is responsible for the timely submission of professional medical claims to various payors.Prepare, review, and transmit claims for electronic and/or paper claim submission from the PM system.Responsible for resolving claim edits and clearinghouse rejections via the PM system.Responsible for processing all secondary claims via electronic and/or paper claim submission.Responsible for submitting claims with required documents, per payor guidelines or as requested (i.e., medical records).Review patient statements for accuracy and completeness prior to billing.Maintain a current understanding of local coverage determinations, payor and coding guidelines to ensure claims are consistently billed properly.Perform charge reconciliation from the daily appointment schedule.Perform posting of charges, electronic and/or manual to the PM system.Keep abreast with medical coding updates and educate team members of changes in a timely manner.The specialist will maintain...