19 coder profee jobs found

ABA Therapy Medical Billing Specialist Job Summary:House of Hearts ABA is seeking a highly experienced ABA Therapy Medical Billing & Credentialing Specialist to join our team full-time.As a critical member of our billing team, you will be responsible for handling both in-network and out-of-network claims, ensuring accurate and efficient billing processes, and maintaining compliance with insurance policies and industry regulations.Responsibilities:Process in-network and out-of-network claims efficiently and accurately Obtain Verification of Benefits (VOBs) and ensure all coverage details are reviewed Manage prior authorizations for ABA therapy services Handle Single Case Agreements (SCAs) and negotiate terms with insurance providers Submit insurance contracts and manage the entire credentialing and contracting process to enroll providers with insurance networks Coordinate all front-desk billing tasks, including managing various insurance portals and direct calls to payers Track...

Overview Baptist Health is the region’s largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 25 years, we’ve been named one of Fortune’s 100 Best Companies to Work For, and in the 2024-2025 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families...

Summary The Medical Biller is responsible for ensuring all providers' encounters are coded, billed and submitted in a timely manner to insurance companies, while also monitoring and resolving any rejections or denials through company billing portals.This position is essential to ensuring clean claim submission, reducing delays in reimbursement, and supporting compliance with payer and CMS guidelines. Essential Duties and Responsibilities Review, verify and submit provider encounters for accuracy in coding and documentation. Ensure timely and clean claim submission through appropriated billing software. Correct and resubmit rejected claims with proper supporting documentation or edits. Communicate with providers and clinical teams as needed to clarify documentation or encounter issues. Work closely with internal MRA coders to resolve discrepancies in diagnosis or procedures codes. Maintain billing logs and status update to ensure all encounters are accounted for and processed....

Sanitas is a global healthcare organization expanding across the United States.Our services include primary care, urgent care, nutrition, lab, diagnostic, health care education and resources for our patients.We strive to attract professionals who believe in our mission, vision and are dedicated to the service of our patients and their families creating a memorable experience through compassion, respect, and kindness. Job Summary The Medical Center Supervisor will be in charge of the successful management and operation of medical practices to include all specialty disciplines and clinic sites.They provide all medical specialists with resources necessary to meet the needs of patients and meet the financial objectives of the practice and group.Management and Leadership skills are essential to the success of this position.The main focus of the Supervisor is to support a team of highly qualified and dedicated staff to provide quality medicine while creating and maintaining the Sanitas...

Job DescriptionLocation 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.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.This position does not have excessive re-bills.ResponsibilitiesReviews 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 rules.Reviews medical records to ensure appropriate documentation is...

2 weeks ago Be among the first 25 applicantsGet AI-powered advice on this job and more exclusive features.Job DescriptionMust live in one of the approved states :Florida, Alabama, Georgia, Louisiana, Tennessee, Texas (excluding Austin, TX), North CarolinaThe Coder II reviews outpatient records and accurately assigns appropriate ICD-10-CM or CPT-4 codes according to established guidelines with a 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.ResponsibilitiesReviews 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 rules.Reviews medical records to...

JOB DESCRIPTIONMust live in one of the approved states :Florida, Alabama, GeorgiaThe 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.This position does not have excessive re-bills.RESPONSIBILITIESReviews 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 rules.Reviews medical records to ensure appropriate documentation is there to support codes / ER charges assigned.Responsible for being knowledgeable of coding and diagnostic procedures, as well as...

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...

JOB DESCRIPTIONLocation 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.The Coder is responsible for ensuring that claims reflect accurate diagnosis as ordered by the health care provider.This position validates that the coding methodology correctly reflects how the tests was performed and meets all state federal local and payer guidance.RESPONSIBILITIESReviews 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 rules.Reviews medical records to ensure appropriate documentation.Responsible for being knowledgeable of coding and diagnostic procedures, as well as remaining current about federal legislative changes that affect outcome.Communicate questions or concerns to the Coding Manager, HIM Services...

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...

Department FPG Central Billing Office Job Summary Identifies 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.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 initiative and the ability to work in a self-directed environment.- Prefer Multi-Specialty coding experience.- Prefer basic knowledge of...

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...

OverviewThe Coder II position assigns diagnoses and procedure codes to Observation and Same Day Surgery medical records.ResponsibilitiesAssigns correct ICD-10-CM code to all diagnoses and correct CPT code to all procedures documented in the medical record.Thoroughly reviews the entire medical record in order to retrieve proper documents (i.e.discharge summary, progress notes, operative report, pathology report, anesthesia report, etc.) to provide coding specificityReads and understands operative reports in order to classify to the most accurate CPT codes.Researches complex operations as necessary.Selects the principal diagnosis and procedure according to the Uniform Health Data Discharge Set definitions and coding rules published in Coding Clinic.Accurately abstracts attending and operating physicians in the Sunrise Record Manager abstracting system.Assigns the correct modifier on CPT codes that are required under the Medicare APC reimbursement.Maintains a thorough knowledge of the...

OverviewTalent Sourcing Specialist at Memorial Healthcare SystemSummaryReviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance.ResponsibilitiesReviews encounters to assign and sequence appropriate diagnoses (including HCC Coding Hierarchical Condition Category) and CPT procedure codes as well as modifiers to complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures.Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.Create electronic physicians queries within allowed scope for hospital outpatient coder.Reviews all appropriate work queues daily to address edits and make corrections following Health Information Management (HIM)...

Must live in one of the approved states :Florida, Alabama, Georgia, Louisiana, Tennessee, Texas (excluding Austin, TX), North CarolinaThe 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.This position does not have excessive re-bills.ResponsibilitiesReviews 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 rules.Reviews medical records to ensure appropriate documentation is there to support codes / ER charges assigned.Responsible for being...

Summary :Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance.Responsibilities :Reviews encounters to assign and sequence appropriate diagnoses (including HCC Coding Hierarchical Condition Category) and CPT procedure codes as well as modifiers to complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures.Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.Create electronic physicians queries within allowed scope for hospital outpatient coder.Reviews all appropriate work queues daily to address edits and make corrections following Health Information Management (HIM) coding policies and procedures.Conducts, audits and / or...

Coding SpecialistAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care.An unwavering commitment to our service vision is what makes the difference.It is the foundation of The Memorial Experience.Reviews medical record documentation.May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas / record types to ensure proper billing and compliance.For physician billing, collaborates with billing department to ensure all bills are satisfied.For hospital, routes to billing charge entry errors and / or account edits preventing completion of coding and / or billing.Makes appropriate coding corrections, when advised, and follows procedure to notify billing.Enhances and maintains coding knowledge and skills.Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes.Seeks...