44 jobs found in Albany

Coding Specialist Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Assigns accurate diagnostic and procedure codes according to clinical documentation and official coding guidelines for outpatient hospital professional accounts Assigns CPT and ICD-10 codes Monitors assigned work queues to ensure all records...

Humana Inc. is seeking an experienced and Certified Inpatient Medical Coding Auditor to review hospital claims and ensure accurate reimbursement. The role involves assigning ICD-10-CM, ICD-10-PCS, and DRG codes, auditing coding quality, and resolving provider disputes. Remote work with occasional travel to Humana offices may be required. Requirements include 4+ years of MSDRG auditing, RHIA/RHIT/CCS certification, and inpatient coding audit experience in health insurance or hospital settings. #J-18808-Ljbffr

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the...

Overview Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. #J-18808-Ljbffr

Albany Medical Center is seeking a Senior Professional Coder to act as service line coding team lead, applying advanced CPT/ICD-10 coding skills and coordinating with staff to ensure timely, accurate professional coding processes. The role involves auditing codes for compliance with CMS and payor guidelines, providing education to providers and staff, supporting HCC/risk adjustment coding, denials analysis, workflow testing, and liaison with external audits; remote work with onsite education as #J-18808-Ljbffr

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Job...

Department/Unit: Physicians Billing Work Shift: Day (United States of America) Salary Range: $46,947.00 - $65,726.00 The Medical Billing Analyst is an intermediate billing position within the Hospital or Physicians Billing Offices for the Albany Med Health System (AMHS). This role is centered around the timely follow up needed on accounts that have already been billed but need re-billing, accounts in which the payer has not responded within the regulatory guidelines, or AMHS has received a denial that needs an immediate action and/or rebuttal. The denials assigned in this role are more intricate than others and the denial response may require a professional narrative accompanied by supporting documentation to be overturned. Some or all these areas may be the focus of the position depending on the resources needed. The incumbent must be able to prove that they have an ability to learn quickly and work independently. They will possess the ability to use payer websites to locate...

A leading health services company is seeking an experienced Inpatient Medical Coding Auditor to perform coding audits and ensure accurate provider reimbursements. This remote position requires certifications such as RHIA, RHIT, or CCS, and proficiency in MS-DRG coding, claims interpretation, and Microsoft Office. Strong communication and detail orientation are essential for success in our supportive, flexible work environment, where candidates will also enjoy competitive benefits and potential bonuses. #J-18808-Ljbffr

Become a part of our caring community The Senior Medical Coding Professional, Inpatient supports payment integrity initiatives by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with official guidelines. You will report to the Manager, Payment Integrity. Key Responsibilities Review inpatient records for coding accuracy and DRG validation Identify anomalies for audit targeting Apply ICD-10-CM/PCS coding guidelines and DRG logic Assess how coding impacts reimbursement and severity adjustment Conduct retrospective audits and document findings Recommend adjustments, recoveries, or provider education Collaborate with clinical reviewers and data analysts Use your skills to make an impact Required Qualifications Required: RHIA, RHIT, CCS, or CIC 5+ years inpatient coding experience Audit or validation experience Strong DRG knowledge (MS-DRG/APR-DRG) Understanding of CDI and severity of illness (SOI/ROM) concepts Preferred Qualifications 3M...

A healthcare provider in Albany, NY, seeks a Medical Billing position. The role entails providing efficient follow-up on accounts and securing revenue for physician services. Candidates should possess a high school diploma or GED, preferably with an AAS degree, and have customer service experience. Key skills include proficiency with office software like Excel and the ability to communicate effectively. This position offers extensive training, Monday through Friday hours with a focus on a fast-paced work environment. #J-18808-Ljbffr

Hospital Coder The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements. Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines. Support the reporting of healthcare data elements (e.g. diagnoses and...

Senior Professional Coder The Senior Professional Coder 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 Responsibilities Review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliance with federal and state regulations and insurance carrier guidelines. Ensuring...

Acute Inpatient Coding Auditor We are seeking an experienced Acute Inpatient Coding Auditor with recent acute care hospital experience. This role is responsible for auditing facility-based inpatient coding, DRG assignment, ICD-10-CM/PCS coding accuracy, documentation review, and compliance. Candidates must have a strong background in acute inpatient hospital coding and auditing. This position focuses exclusively on facility (hospital) inpatient services and is not a professional fee/physician coding role. Job Summary: Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure...

Job Summary: We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must be CPC and CRC certified with strong risk adjustment coding expertise and proficiency in Microsoft Office Suite. Required Skills: 8+ years of Risk Adjustment coding and auditing experience Experience supporting CMS RADV first- and second-pass audits Active CPC (Certified Professional Coder) certification Active CRC (Certified Risk Adjustment Coder) certification Proficiency in Microsoft Office Suite (Excel, Word, Outlook) This is a remote position.

Albany Med Health System seeks a Medical Billing Associate to support the Hospital or Physician Billing Offices at 1275 Broadway, Albany. The role emphasizes timely billing, pre-billing edits, and initial payer denial resolution within the AMHS network. Responsibilities include handling denials, re-billing, and appeals, while maintaining clear notes and meeting daily production standards. Collaboration with peers and leaders is essential in improving claim quality. #J-18808-Ljbffr

Albany Med Health System is seeking a Medical Billing Associate for the Patient Billing Service in Albany, NY. The role focuses on timely, accurate pre-billing edits and introductory denial resolution to ensure clean claims are sent to payers. Responsibilities include resolving edits, handling denials through re-billing or disputes, and communicating payer trends to leadership to minimize aging AR, all while maintaining high productivity and QA standards. #J-18808-Ljbffr

Qualifications High School Diploma or GED (Required) Vocational / Technical Degree (Preferred) 2 year / Associate Degree in Health Information Management (Preferred) Work Experience 2-3 years Diagnosis and CPT coding in a clinic, business, or revenue cycle environment or any combination thereof. (Preferred) 2-3 years Broad knowledge of medical terminology and anatomy. (Preferred) Licenses and Certifications Required Certifications/Licensures: Coding Certification (CPC or CCS) Preferred Certifications/Licensures: CPMA Essential Functions CODING SKILLS Review medical records to assign ICD-10-CM, CPT, and HCPCS Level II codes and modifiers for accurate primary and multi-specialty billing. Provides analysis and education on coding trends and changes in payer policies to providers and staff. CODING REVENUE CYCLE SKILLS Review claim denials for coding issues, interpret payer guidelines, and assist insurance collectors with resolution for proper reimbursement. Prepare or...

Job Information Job Number: 32909 Location: Phoebe North Campus, 2000 Palmyra Rd, Albany, Georgia 31701 Department: PPG CBO; Shift: –; Job Type: Full time; Posted Date: 2025-10-30 Job Description Summary Classify medical data from patient records to assign ICD-10-CM and CPT codes for primary and multi-specialty physician billing. Reviews clinical billing for coding and billing accuracy. Review claim denials for coding-related issues and assist CBO collectors with resolution. Demonstrate knowledge of reimbursement guidelines and changes in payer policy. Provide guidance to clinical staff and providers where necessary. Serves as a resource for clinics on coding issues and questions as needed. May supervise an individual billing team of non-certified billers and collectors. Performs research on coding changes and payer policies on an ongoing basis. Qualifications High School Diploma or GED (Required) Vocational / Technical Degree (Preferred) 2 year / Associate Degree in Health...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location (Full Address): Remote Work - New York, Albany, New York, United States of America, 12224 Opening: Worker Subtype: Regular Time Type: Time as Reported / Per Diem Scheduled Weekly Hours: As Scheduled Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.27 - $32.60 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%) Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources...

• Medical Billing Associate handles billing and follow up of medical claims • Focus on pre-billing edits and introductory payer denials • Initiate appeals or rebill claims to address denials • Work independently to meet production standards • Communicate with peers, trainers, and leaders • Resolve billing edits and respond to denials on accounts as assigned • Collaborate with internal/external departments as needed • Recognize payer trends and communicate them to leaders Requirements High School Diploma ATS Optimization Keywords Below are skills and terms extracted directly from this job posting to improve Applicant Tracking System (ATS) visibility. This unique feature helps candidates tailor their applications more effectively — a feature exclusive to JobTailor job listings. Soft Skills independent work communication collaboration problem-solving #J-18808-Ljbffr

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

Baylor Scott & White Health in Albany, NY is seeking a Billing Representative to submit hospital or professional claims to a range of payers. You will audit codes, correct demographics, and ensure accurate submissions end-to-end. The role requires attention to detail and ability to resolve payer rejections, with opportunities to work with multiple insurance lines and support the billing workflow. #J-18808-Ljbffr