7 senior risk adjustment coder jobs found

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...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Responsible for providing accurate, reliable and effective education to physicians and extenders regarding outpatient procedural and diagnosis coding. This position performs individual and group documentation reviews, identifies opportunities for improvement, assists with implementation of physician lead CME documentation and coding courses and coordinates with physician...

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...

Department / Unit :Health Information ManagementWork Shift :Day (United States of America)Salary Range :$60,367.47 - $90,551.20This position is Fully RemoteProfessional 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.Act as an expert for the HCC / Risk adjustment coding.This position is remote but does require onsite education to providers as needed.Essential Duties and ResponsibilitiesReview, analyze, and validate CPT and ICD-10 diagnosis codes and...

TITLE :Medical Billing Specialist on site in Kenai AlaskaREPORTS TO :CFOWORK WEEK :Hours not to exceed 40 per weekWAGE CLASSIFICATION :Non-exempt $21.00 per hourOSHA RISK CLASSIFICATION :LowSUMMARY POSITION STATEMENTThis position exists to ensure the financial well-being of the PCHS organization through timely and accurate filing of insurance claims and collection of patient accounts and ensure proper posting of payments into existing PCHS systems for medical dental optometry and / or behavioral health.This position may be responsible for any or all the essential functions listed below in the electronic health record systems.ESSENTIAL FUNCTIONS / ROLES & RESPONSIBILITIES OF THE POSITIONCollaborate with staff providers team members patients and insurance companies to get all claims processed and paid.Capable of performing all aspects of medical billing independently including but not limited to charge entry posting insurance payments rejections and follow-up.Assign correct...

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...