23 payment integrity coder jobs found

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 /...

Job Summary A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines. Core Duties & Responsibilities Evaluates the appropriateness of codes and determine whether they meet all established program standards. Ensures that the medical records are matched appropriately to the codes and if not, obtains them. Read & apply policy guidelines and healthcare terminology and delineate when criteria are/are not met. Evaluates claims for conflict of interest and criteria appropriateness. Works within established timeframes set by program parameters. Provides strong customer service skills and works closely...

Job Summary A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines. Core Duties & Responsibilities Evaluates the appropriateness of codes and determine whether they meet all established program standards. Ensures that the medical records are matched appropriately to the codes and if not, obtains them. Read & apply policy guidelines and healthcare terminology and delineate when criteria are/are not met. Evaluates claims for conflict of interest and criteria appropriateness. Works within established timeframes set by program parameters. Provides strong customer service skills and works closely...

Inpatient Hospital Certified Medical Coder III - remoteAre 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,...

Job DetailsJob LocationAmberwell Hiawatha - Hiawatha, KSRemote TypeFully RemotePosition TypeFull TimeEducation LevelOtherJob Shift8 Hour DayJob CategoryHealth Information ManagementDescriptionBASIC FUNCTION :Reviews patient records and assigns accurate codes for each diagnosis and procedure on the accounts assigned to coder.Applies knowledge of medical terminology, disease processes, and pharmacology.Demonstrates tested data quality and integrity skills.Performs chart verification as assigned.Performs final chart reviews as necessary.SHIFT DAYS / HOURS :Remote PositionFull-Time :40 Hours per Week, Monday through Sunday.Hours and Days are Subject to change based on business necessity.ESSENTIAL FUNCTIONS :Review and abstract patient medical records.Report diagnoses, treatments, as well as surgical and non-surgical procedures for CAH facility medical services.Perform coding duties of discharged patient medical records using AHA Coding Clinic for ICD-10-CM and ICD-10-PCS, AHA Coding...

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...

OverviewNAH reserves the right to make hiring decisions based on applicants state of residence if outside the state of Arizona.NAH currently hires for remote positions in the following states :AlabamaArizonaFloridaGeorgiaIdahoIndianaKansasMichiganMissouriNorth CarolinaOhioOklahomaPennsylvaniaSouth CarolinaTennesseeTexasVirginiaThe Coder 3 electronically records stores and reports on reams of data.Responsible for coding the following service types based on department and assignments.Facility HIM :Inpatient outpatient emergency room and outpatient clinical.Ambulatory :Coding and auditing professional inpatient outpatient emergency and clinic.Coders will need to apply a broad knowledge of procedure coding diagnosis coding medical terminology and anatomy / physiology.Hospital Coder Proficiency :ICD-10 PCS / DRG / CPT / HCPCS / ICD-10 CM.Professional Coder Proficiency :CPT / HCPCS / ICD-10 / CM.ResponsibilitiesCommunicationWorks in collaboration with physicians in tracking un-coded...

Job DescriptionThe Hospital Inpatient Coding Specialist reviews inpatient medical records and assigns International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10 CM) diagnosis and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) procedure codes that derives an All Patient Refined Diagnosis Related Group (APR-DRG) or Medical Severity Diagnosis Related Group (MS-DRG) for optimal reimbursement.The Hospital Inpatient Coding Specialist will work in collaboration with the Clinical Documentation Integrity Specialist at times to ensure accuracy consistent with Centra's coding policies.The Hospital Inpatient Coding Specialist will abstract pertinent information according to established guidelines for the organization and will formulate provider queries to clarify information.ResponsibilitiesAssigns diagnosis and procedure codes.Verifies accuracy of DRGAccurately abstracts required information.Initiates provider coding...

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...

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 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...

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...

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...

Overview Employer Industry: Healthcare Services Why consider this job opportunity: Estimated pay range of $26.13 - $33.97 per hour, depending on experience Opportunity for career advancement and growth within the organization Supportive and collaborative work environment focused on quality care Chance to make a positive impact on coding compliance and education for healthcare providers Work with a renowned healthcare organization recognized for excellence in patient care What to Expect (Job Responsibilities) Perform comprehensive audits to assess the integrity of coding and billing for physician and clinical fees Identify and correct documentation, coding, and billing errors as well as evaluate medical necessity of services billed Develop and execute educational opportunities and resources based on audit results and coding compliance trends Lead provider education events to discuss audit results and implement action plans Establish positive working relationships as a subject...

Join CommunityThe Innovative Healthcare Collaborative of Indiana (IHCI) is a joint venture between Community Health Network and Deaconess Health system.Its goal is to support our sponsors and partners in their strategic evolution to positively impact and improve the healthcare delivery system.Make a DifferenceReporting to the Clinical Documentation Integrity Manager this role performs patient chart reviews to ensure the appropriateness andcompleteness of diagnostic coding with evidence based on CMS HCC standards.The Risk Adjustment Coder is responsible for :Timely accurate and complete review of patient charts following patient encounters utilizing a variety of technical platforms to completeworkflowsValidating diagnosis codes representing patient conditions along with necessary MEAT documentationEnsuring coding is consistent with guidelines from regulatory entitiesConducting audits to meet compliance with ACA standardsCreating post-visit queries with follow upCollaborating with...

Job SummaryUnder the general supervision of Manager and direct supervision of Supervisor, following established policies, procedures and professional guidelines, the Coder 2 will :Perform a thorough review of medical record documentation to accurately assign diagnosis and procedure codes.Utilize the encoder system to sequence the codes assigned and calculate the corresponding MS-DRG / APR DRG / APC grouper.Abstract patient information into the computerized medical record and billing systems, ensuring the accuracy and integrity of the medical record data abstracted and encounter information prior to finalizing the encounter.Collaborate with the Clinical Documentation Improvement Team, Coding Team Coordinators and / or Supervisor to query for clarification of ambiguous documentation or, patient diagnostic and procedural information in the medical record.Be knowledgeable in the requirements of the industry with regard to Medicare and / or Managed care regulations, the International...

Quadris Team, LLC - A Revenue Cycle Management Group, is searching for a dynamic person to join us, working with our highly skilled Medical Coding Team to fill the role of Medical Coding Auditor & Educator.We are a 100% remote team supporting our clients across the United States! See us at.The ideal applicant will be a subject matter expert in both Facility and Profee medical coding auditing.Job Focus :The Senior Coding Auditor may be responsible for a variety of duties and obligations, depending on the client and assignment.These responsibilities may include inpatient / outpatient / professional fee facility auditing, denial management, coding, implementation specialist, job aid creation, training, and specialty coding.The position may also be responsible for management of the audit team and project management.All coding and auditing are performed within the scope of regulatory and compliance law expectations.Auditing Responsibilities :May include conducting inpatient,...

Job DescriptionJob DescriptionQMACS, Inc., a well-established medical billing company located in Richardson, Texas, has an opening for an experienced emergency department coder.The right candidate should be able to code both professional and facility charts; adhere to coding policies and procedures consistent with the industry standard guidelines for CPT, ICD-10, HCPCS and ACEP coding and reporting.The ideal candidates should have the ability to work within a team environment to ensure optimal revenue attainment and complete compliance with governmental and private payor requirements.AAPC and / or AHIMA Medical Coding Certification is required.Experience is preferred.RequirementsExperience coding Emergency Department chartsKnowledge of HITECH & HIPAA compliance rules and regulations requiredAbility to work well with Microsoft Office suite of products, particularly ExcelAbility to work in and / or familiarization with a variety of EHR products is a plusKnowledge of facility AND...

We are seeking experienced and highly accurate Value-Based Coders to join a project dedicated to in-home health assessments for Medicare Advantage and other value-based programs.This role is 100% remote and ideal for coders who are confident working independently, detail-oriented, and committed to quality and compliance.As a contractor, you'll have the independence to manage your own schedule while contributing to meaningful work that truly makes a difference.As part of the coding team, you will review clinical documentation from in-home visits and assign complete and compliant ICD-10-CM diagnosis codes that reflect the full spectrum of each patient's health.This includes :Risk adjustment (HCC) diagnoses aligned with CMS-HCC and HHS-HCC models.Social Determinants of Health (SDOH) codes.Medication-related Z codes, such as long-term drug therapy and treatment monitoring.All other clinically relevant diagnoses supported by documentation.Your accuracy directly supports the integrity of...

Job DescriptionJob DescriptionMedical Coding Compliance SpecialistCompensation :Up to $85,000 annually, determined by your experience and qualifications.Job Location :Remote (US)Job Highlights :Work-Life Balance :Monday to Friday schedule for a fulfilling personal and professional life.Competitive Compensation :Be rewarded with a generous salary and benefits package.Career Growth Opportunities :Unlock your potential and advance in your career with our support.Supportive Work Environment :Join a team that values and appreciates your contributions.Comprehensive Training :Enhance your skills and knowledge through our extensive training programs.Compliance and Peace of Mind :Work with confidence knowing that we prioritize compliance with employment laws and regulations.Paid Time Off and Holidays :Enjoy well-deserved time off to relax and recharge.Life Insurance Coverage :Protect your loved ones with our employer-paid life insurance policy.Collaborative Team Environment :Thrive in a...

Job Title Senior Inpatient Coder - CH Health Information Mgmt (Remote) - FT/Days at Centra Health The Hospital Inpatient Coding Specialist reviews inpatient medical records and assigns ICD-10-CM diagnosis and ICD-10-PCS procedure codes that derive an APR-DRG or MS-DRG for optimal reimbursement. The specialist may collaborate with the Clinical Documentation Integrity (CDI) Specialist to ensure coding accuracy in line with Centra’s policies. The specialist abstracts pertinent information according to established guidelines and formulates provider queries when clarification is needed. Responsibilities Assigns diagnosis and procedure codes. Verify the accuracy of DRGs. Accurately abstracts required information. Initiate provider coding queries in compliance with coding guidelines and policies where appropriate. Meet productivity standard of 2 charts per hour or higher. Meet coding accuracy of 95% or higher. Verify and assign discharge status codes. Ensure presence of a completed...

Associate Director, Scientific Publications Medical Writer-Viral Hepatitis & Inflammation Associate Director, Scientific Publications Medical Writer-Viral Hepatitis & Inflammation United States - California - Foster City Medical Affairs Regular Job Description At Gilead, we’re creating a healthier world for all people. For more than 35 years, we’ve tackled diseases such as HIV, viral hepatitis, COVID-19 and cancer – working relentlessly to develop therapies that help improve lives and to ensure access to these therapies across the globe. We continue to fight against the world’s biggest health challenges, and our mission requires collaboration, determination and a relentless drive to make a difference. Every member of Gilead’s team plays a critical role in the discovery and development of life-changing scientific innovations. Our employees are our greatest asset as we work to achieve our bold ambitions, and we’re looking for the next wave of passionate and ambitious...