72 jobs found in Boston

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...

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...

Signature Performance is seeking an Inpatient Professional Fee, Profee Medical Coder to join our remote team. This role focuses on accurate E/M coding, ICD-10-CM/PCS, CPT and HCPCS coding for inpatient encounters, ensuring compliant documentation and optimal reimbursement. The ideal candidate has 2+ years of professional fee coding experience, AHIMA or AAPC credentials, and proficiency with EHR systems. This is a nationwide remote position with standard CST hours and competitive compensation. #J-18808-Ljbffr

Public Safety Operations Supervisor.Assists in the planning and organizing of effective delivery of security services to the medical center.Ensures customer satisfaction in the Public Safety Depart... Show more $51.50 hourly Full-time Site: The Brigham and Women's Hospital, Inc.Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts... Show more $115,000.00 yearly Full-time Primarily responsible for providing effective safety management services for all Region and Field employees by utilizing professional workplace safety problem-solving and relationship skills.Proact... Show more Full-time Supports Chief Medical Physicist and Radiation Safety Officer in Medical Physics and Radiation Safety compliance related activities at Boston University (BU) and Boston Medical Center (BMC).Assists... Show more Full-time Representing a leader in the industry, we are searching for an...

CVS Health in New Hampshire is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit, ensuring coding accuracy and compliant documentation across medical, behavioral, transportation and other healthcare services. The role requires CPC certification, 3+ years of coding or auditing, and strong knowledge of CPT/HCPCS/ICD-10, CMS 1500/UB04, plus proficiency with Excel and Word. #J-18808-Ljbffr

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements.This is a hybrid position: 2 days onsite; 3 days remote option. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process. Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC's, PCS and ICD-10-CM codes. Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code...

Inpatient Lead Coder - Remote Assigns appropriate codes to reflect all diagnoses and procedures extrapolated from physician and appropriate nursing documentation during a patient encounter according to the most current coding methodologies, including ICD-10-CM/PCS, resulting in appropriate reimbursement. Abstracts required data to input into the Medical Center's computerized data base. Converts all patient visits and encounters into appropriate DRG (Diagnosis Related Group) assignments in order to correctly submit the optimal reimbursement for each patient encounter coded. Assists the IP Coding Manager in administrative duties such as assignment of coding work, analysis of the unbilled report, and other duties as assigned. Essential Responsibilities / Duties: Assists IP Coding Manager with assignment of work to Coders, analysis of the daily unbilled report, and follow-up on unanswered physician queries and missing documentation. Assists PFS in researching unbilled accounts...

Senior Medical Coding Analyst CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix's autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meetsand exceedsour customers' coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding...

Serco is seeking Medical Coding Auditing Specialists to support the Defense Health Agency’s Medical Coding Program Branch. You will perform routine and targeted audits across DHA facilities, help develop annual audit plans, and support reporting and process improvements in a complex government environment. Qualified candidates bring extensive medical coding/auditing experience, ICD-CM/PCS knowledge, and familiarity with DRGs and PPS. #J-18808-Ljbffr

Company Description SOLVD Health is dedicated to building a world where individuals can avoid becoming patients by focusing on disease prevention and proactive care. The company’s mission is to make actionable, contextual health information accessible to everyone through its Patient Intelligence approach. SOLVD Health tackles complex healthcare challenges to drive meaningful, lasting improvements in people’s lives. The Medical Billing Specialist is responsible for ensuring accurate coding, claims submission, payment tracking, insurance verification, and follow-up with patients and healthcare providers. Education and Experience Bachelor’s degree in business, finance or accounting preferred. Minimum three (3) years of experience in medical laboratory claims coding and billing role. Certification in medical billing and coding preferred. Knowledge and understanding of medical laboratory operations and processes. Proficient in Quadax revenue cycle management software. Strong knowledge...

POSITION SUMMARY: Assigns appropriate codes to reflect all diagnoses and procedures extrapolated from physician and appropriate nursing documentation during a patient encounter according to the most current coding methodologies, including ICD-10-CM/PCS, resulting in appropriate reimbursement. Abstracts required data to input into the Medical Center’s computerized data base. Converts all patient visits and encounters into appropriate DRG (Diagnosis Related Group) assignments in order to correctly submit the optimal reimbursement for each patient encounter coded. Assists the IP Coding Manager in administrative duties such as assignment of coding work, analysis of the unbilled report, and other duties as assigned. Position : Inpatient Lead Coder Department : Clinical Documentation Schedule : Full Time ESSENTIAL RESPONSIBILITIES / DUTIES: Abiding by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adhering to...

Southern New Hampshire Health is seeking a Certified Medical Coding Specialist for the Emergency Department, working remotely in New Hampshire. The role focuses on accurate ICD-10-CM, CPT, and HCPCS coding for professional and facility services, with collaboration across ED providers, CDI, and revenue cycle teams. The ideal candidate has ED coding experience in an acute care hospital, CCS or COC certification, and proficiency with Epic and encoder software. #J-18808-Ljbffr

The Clinical Educator, reporting to the Medical Laboratory Science Program Director, plays a key role in delivering and advancing hospital-based education programs within the Department of Pathology. The position focuses primarily on teaching (70%), including delivering lectures, leading lab and case-based instruction, developing curriculum, assessing student performance, and supporting learner success. The educator also ensures content stays current with clinical practices and collaborates on curriculum improvement. The remaining 30% of the role involves departmental service, including supporting program growth, student recruitment, community outreach, and workforce development initiatives. The educator contributes to expanding educational programs, assisting with admissions, engaging with prospective students, and helping develop training opportunities for both new and practicing laboratory professionals. Education Bachelor's Degree Medical Laboratory Science required or...

Job Description About the role: As a member of Takeda Oncology, your work will contribute to our bold, inspiring vision: We aspire to cure cancer. Here, you'll build a career grounded in purpose and be empowered to deliver your best. As part of the Global Medical Affairs Oncology team, you will report to the Scientific Communications Group Lead, Solid Tumors. As a subject matter expert on scientific publications best practices and the development of scientific communication strategy and deliverables, the Associate Director, Scientific Communications Lead, proactively defines and drives the publication and scientific communication strategic plan and deliverables for the assigned oncology assets based on medical strategies, transparency requirements, and data availability. This position requires a strong scientific and analytical background, preferably in life sciences, and excellent project management skills. The Associate Director, Scientific Communications Lead, develops and...

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. This is a hybrid position: 2 days onsite; 3 days remote option. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.    Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.    Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code...

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. This is a hybrid position: 2 days onsite; 3 days remote option. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.    Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.    Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code...

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. This is a hybrid position: 2 days onsite; 3 days remote option. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.    Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.    Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code...

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. This is a hybrid position: 2 days onsite; 3 days remote option. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.    Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.    Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code...

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Competitive Pay / Full time, 4x10 shifts Job Summary The Clinical Educator, reporting to the Medical Laboratory Science Program Director, plays a key role in delivering and advancing hospital-based education programs within the Department of Pathology. The position focuses primarily on teaching (70%), including delivering lectures, leading lab and case-based instruction, developing curriculum, assessing student performance, and supporting learner success. The...

Job Description Summary The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. This is a hybrid position: 2 days onsite; 3 days remote option. Job Description Job Responsibilities: Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.    Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.    Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code...

A leading healthcare institution is seeking a Clinical Educator to develop and teach hospital-based education programs. The role includes delivering lectures, curriculum development, and mentoring students while ensuring current clinical practices. Applicants must hold a Bachelor's degree related to Medical Laboratory Science and possess a minimum of 3 years of relevant experience. This full-time position is located onsite in Boston with a competitive salary range between $79,560 and $115,720 annually. #J-18808-Ljbffr

Job Description Come work at the best place to give and receive care! Job Description: Preferred candidate locations in New Hampshire and Massachusetts ED coding experience required. Who We Are Southern New Hampshire Health has been a cornerstone of the region since 1893, delivering high-quality, compassionate care close to home. Anchored by Southern New Hampshire Medical Center—a 188-bed, DNV-accredited hospital in downtown Nashua with a Level III‑N trauma center, Level II Special Care Nursery, and Magnet designation for nursing excellence—we offer a full spectrum of services from primary care to advanced diagnostics and specialized treatments. Our medical staff includes over 500 providers from Foundation Medical Partners and local practices. Foundation Medical Partners, our multi‑specialty group, spans 70+ practices across southern New Hampshire and northern Massachusetts, providing coordinated, patient‑centered care to thousands each year. About the Job The Coding Specialist –...

Boston Medical Center is seeking a Coding Specialist responsible for assigning codes reflecting diagnoses and procedures according to the latest coding methodologies. This role ensures appropriate reimbursement through accurate coding and collaboration with relevant departments. The successful candidate will have an Associate's Degree in Health Information or a comparable program along with a minimum of five years inpatient coding experience. A competitive salary range of $62,500 – $91,000 is offered, along with comprehensive benefits. #J-18808-Ljbffr