46 lead coder jobs found

Job Overview We are seeking an energetic and detail-oriented Lead Coder to oversee medical coding operations within our healthcare organization.The ideal candidate will possess extensive knowledge of medical coding standards, and revenue cycle processes to optimize clinical revenue and ensure seamless insurance third-party billing.Responsibilities Lead coding team to ensure accurate and timely coding and submission of claims.Oversee compliance with medical billing regulations, including Medicare and Medicaid regulations.Review medical records for proper ICD (International Classification of Diseases) coding and ensure adherence to healthcare billing standards.Maintain up-to-date knowledge of health insurance policies, Medicare, Medicaid, and other third-party payer requirements.Collaborate with clinical staff to verify documentation accuracy in electronic health records (EHR) systems.Monitor revenue cycle management processes from patient registration through final payment...

UnitedHealth Group seeks an experienced Medical Coder with leadership responsibilities to oversee a surgical coding team remotely across the United States. You will ensure accurate CPT/HCPCS/ICD-10 coding, collaborate with physicians and staff, and drive compliant coding practices while maximizing revenue. Strong communication and Epic proficiency are essential, with telecommuting flexibility and adherence to regulatory standards. #J-18808-Ljbffr

Humana Inc. is seeking a Senior Medical Coding Professional (Inpatient) to support payment integrity by reviewing inpatient claims for coding accuracy and DRG assignment. You report to the Manager, Payment Integrity and collaborate with clinical reviewers and data analysts. The role requires RHIA/RHIT/CCS/CIC certification and 5+ years inpatient coding experience, with strong DRG knowledge and CDI/SOI concepts. Remote/hybrid work options are available within the Humana network. #J-18808-Ljbffr

Humana, Inc. is seeking a Senior Medical Coding Professional, Inpatient to support payment integrity by reviewing inpatient claims for coding accuracy, DRG assignment, and guideline compliance. You will report to the Manager, Payment Integrity. The role involves auditing inpatient records, applying ICD-10-CM/PCS guidelines, and collaborating with clinical reviewers to ensure accurate reimbursement and SOI/ROM assessments. #J-18808-Ljbffr

Company Overview :Read on to fully understand what this job requires in terms of skills and experience If you are a good match, make an application.Upward Health is an in-home, multidisciplinary medical group providing 24 / 7 whole-person care.Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help.Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients.We are able to treat a wide range of needs - everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals - because we know that health requires care for the whole person.It's no wonder 98% of patients report being fully satisfied with Upward Health!Job Title & Role Description :The Certified Medical Coder is responsible for analyzing provider documentation to accurately select ICD-10 and CPT / HCPCS...

About Us: At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact—whether we’re supporting data-driven decisions, modernizing systems or safeguarding critical programs. Job Overview We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD-9-CM/ICD-10-CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality...

About Us: At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact-whether we're supporting data-driven decisions, modernizing systems or safeguarding critical programs. We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD‑9‑CM/ICD‑10‑CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality assurance efforts....

Overview To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values.These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.Reporting to the Supervisor of Outpatient Coding, The OP Senior Coder is a vital multifaceted role within the Outpatient Coding Department.This position provides support to the Outpatient Coding Department as a OP coding subject matter expert, educator, QA reviewer, and also focuses daily efforts on A/R management and oversight.Additionally, this person works with partner departments to problem solve issues and streamline processes.The OP Senior Coder is also required to mentor other team members and also prepare them for the role of OP Senior Coder.The OP Senior Coder possesses a strong level of OP clinical coding expertise, and has the ability to handle multiple priorities.This position...

Job Title :Medical Coder Coordinator Location :Fully remote Duration :6 Monthscontract (possibilities of extension “ temp to perm) Shift :from Monday to Friday. 9 am to 5:30 pm Pay Rate:$21.42/Hour. on W2 Job Description:We are seeking a highly motivated and detail oriented professional to join our team and perform retrospective payment reimbursement reviews. The ideal candidate thrives in a fast paced, deadline driven environment and can effectively manage multiple priorities with accuracy and efficiency. This individual must have a strong understanding of how modifiers impact reimbursement and how CPT codes interact with one another. The candidate should also be proficient in reading and interpreting Explanations of Benefits (EOBs), including recoupments, corrections, and other claim adjustments. Additionally, a broad and in depth knowledge of CPT codes across all provider specialties is essential. Requirements: 1year of recent experience as a medical...

Medical Coder Job Duties:Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.Researches and analyzes data needs for reimbursement.Analyzes medical records and identifies documentation deficiencies.Serves as resource and subject matter expert to other coding staff.Reviews and verifies documentation supports diagnoses, procedures and treatment results.Identifies diagnostic and procedural information.Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines.Follows coding conventions. Serves as coding consultant to care providers.Identifies discrepancies, potential quality of care, and billing issues.Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and...

Ceris Certified Coder ICeris is seeking a Certified Coder. The Ceris Certified Coder reverse codes previously coded medical bills to determine coding accuracy. This is a remote role.Essential Functions & Responsibilities:Receives claim and processes based on state rules and regulationsDetermines validity and compensability of the claim using CorVel proprietary programsMakes recommendations to referring officeCommunicates claim status with referring officeReads and comprehends all medical reportsAdheres to client and carrier guidelines and participates in claims review as neededAssists other claims professionals with more complex or problematic claims as necessaryAdditional duties/responsibilities as assignedComplies with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (IIPP), as well as, maintains HIPAA complianceKnowledge & Skills:Ability to learn rapidly to develop knowledge and understanding of claims practiceStrong...

GoTo Telemed seeks an exceptional Remote Medical Biller to manage comprehensive Revenue Cycle Management (RCM) operations for our rapidly expanding telehealth platform serving multiple medical specialties and healthcare providers nationwide.As a key member of our distributed RCM team, you will process, manage, and optimize medical claims for an increasing portfolio of telehealth providers--with new clients and provider networks added every month as our organization scales.In this critical role, you will be the financial backbone of our provider network, managing the complete end-to-end billing lifecycle including patient eligibility verification, insurance claim submission, payment posting, accounts receivable follow-up, and comprehensive denial management.Your expertise in medical coding (CPT, ICD-10-CM, HCPCS), telehealth modifiers, payer policies, and compliance will directly impact provider revenue, patient satisfaction, and our organizational growth trajectory.This position...

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...

Remote Op CoderThe Op Coder works outpatient coding related alerts / edits for Same Day Surgery, Observation, and Wound Care, accounts, predominately post initial / final coding.The CARS-II performs the alert / edit resolution activities in the applicable systems.The alerts / edits shall be worked and corrected according to the established procedures and thresholds, and communicated as appropriate.Position Duties :Compiles daily work list from eRequest, CRT and / or other alert / edit systemsTakes action and resolves alerts / edits for the following patient types following established procedures and thresholds :Same Day Surgery (SDC)Observation (OBV)Wound CareOutpatient Cardiac CathProvides back up / coverage as needed for :Emergency Dept (ED)Recurring (RCR)Clinical (CLI)Provider Office Visit (POV), as applicableEnters detailed notes to update eRequest to provide details if the alert / edit cannot be resolved or must be rerouted to another responsible party for research /...

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...

Are you a detail-oriented Certified Medical Coder who takes pride in accuracy and contributing to quality patient care? We#re looking for someone just like you to join our growing healthcare family at Valleywise Health.As a key member of our team, you#ll play a vital role in ensuring that patient services are accurately coded and reimbursed, helping our clinical teams continue to deliver excellent care.You#ll be surrounded by a supportive team, gain access to ongoing professional development, and have a direct impact on our hospital#s mission to serve the community with compassion and integrity.If you#re a certified medical coder who values accuracy, efficiency, and being part of a healthcare team that truly makes a difference - we want to hear from you! Why You#ll Love Working With Us :# Meaningful Impact :We value you! Accurate medical coding is more than just numbers - it#s about ensuring the integrity of patient care, supporting proper reimbursement, and safeguarding the...

Medical Records Coder, LTAC, Part-time (Remote)Louisville, Kentucky Facility ScionHealth Corporate Support CenterReq ID 545469 Post Date 08 / 05 / 2025 Category Medical CodingDescriptionAt ScionHealth , we empower our caregivers to do what they do best.We value every voice by caring deeply for every patient and each other.We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking.Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.Job SummaryCodes medical records, including all diagnoses, operative and diagnostic procedures in patient medical records, using the International Classification of Diseases and enters coded information into an automated systemEssential FunctionUsing the coding system, assigns and records an accurate code to all diagnoses, procedures, and operations as documented in the patient medical record based on official coding guidelinesEnsures...

Department / Unit :Health Information ManagementWork Shift :Day (United States of America)Salary Range :$60,367.47 - $90,551.20Professional Coding Auditor will apply an advanced professional coding skill set to act as a service line coding team lead expert, working collaboratively to support all workflows related to professional fee coding / charging / denials follow-up.Coordinates with others as needed to ensure comprehensive and timely completion of professional coding processes.Audit CPT and ICD-10 diagnosis coding applied by providers and coding staff to assure compliance with federal and state regulations and insurance carrier guidelines.Provide education, instruction and training to providers and coding staff.This position is remote but does require onsite education to providers as needed.This position has remote opportunityThis position requires a CPC Certification - Upon HireTwo years or more prior experience in professional fee coding - requiredEssential Duties and...

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...

Department:10116 Enterprise Corporate - Administration: Medical Staff ServicesStatus:Full timeBenefits Eligible:YesHours Per Week:40Schedule Details/Additional Information:This role covers two hospital sites Condell Medical Center and Good Shepherd Hospital. It is also hybrid. 2-3 days a week in office and the rest from home.Pay Range$30.70 - $46.05Leads, plans, organizes and is responsible for the day to day operations of the Medical Staff Services Department so that all aspects of the Organized Medical Staff are supported, including credentialing activities, professional relations, meeting management, and peer review activities. Additionally, compliance is maintained, with accrediting and regulatory agencies as related to the Medical Staff, including (but not limited to) Joint Commission, DNV, HFAP, CMS, OSHA, and State and Federal Law and other standards and regulations.Major Responsibilities:Implements, coordinates, monitors, and maintains effective credentialing processes for...

The Center for Technology Licensing at Cornell University seeks an Associate Director for Business Development and Licensing with a focus on biomedical technology. Well-qualified candidates will possess prior experience assessing inventions, developing business, and negotiating contracts in the technology transfer field.The RoleAs Associate Director for Business Development and Licensing, you will contribute your forward-thinking perspective to a leadership team driving a comprehensive technology commercialization and partnership program. You will manage a large biomedical technology portfolio and serve as the primary liaison with faculty and research staff in designated research areas.Key responsibilities will include:Helping faculty and researchers crystallize inventive ideas and disclose inventions, tangible and copyrightable materials to the UniversityContinuously assessing business needs in target industries by establishing, maintaining, and growing business development...

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...