73 certified coder jobs found in Boston

The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with the Plans’ provider agreements and the National Healthcare Billing Audit guidelines. The successful candidate must be capable of building and maintaining strong working relationships with key internal and external constituents and working effectively in a matrixed environment. Responsibilities include: Work with SIU Investigators assisting in research, discuss to make appropriate coding determinations as needed Analyze and interpret patient medical records (behavioral related and other specialties) pertaining to FWA investigations as needed Compare information submitted on the claims to determine amount and nature of billable services as needed Determines appropriateness of billing and reimbursement as needed Documents findings for each claim line in a spreadsheet as needed Summarize findings in a...

Inpatient Coder (CCS Certified) – Remote Location: Remote (work from home office) Experience: 3+ years of facility-based inpatient coding Job Summary The Inpatient Coder is a key role supporting one or more Cognizant clients, responsible for reviewing medical documentation and accurately assigning ICD-10-CM diagnosis and ICD-10-PCS procedure codes. This role works independently and as part of a team, queries physicians to clarify documentation, and supports coding quality through peer review, while meeting accuracy and productivity standards in a fast-paced remote environment. Key Responsibilities Review documentation to code diagnoses (ICD-10-CM) and procedures (ICD-10-PCS). Communicate with physicians to obtain or clarify diagnoses and/or procedures through the query process. Assign accurate codes using an electronic encoder application in accordance with practice policy and regulatory guidelines. Perform peer reviews of company Health Information Management coding...

Elliot Health System is seeking a Hospital Inpatient Coder for Revenue Integrity in a remote, full-time capacity. The role focuses on accurate ICD-10 and DRG coding for hospital inpatient services, ensuring compliance and optimal reimbursement. The position requires at least 2 years of coding experience and current CCS certification, with a strong emphasis on audits, deadlines, and adherence to coding standards. #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. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical...

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina Alabama Arizona Connecticut District of Columbia Florida Georgia Illinois Iowa Kentucky Louisiana Maine Michigan Missouri Montana New Hampshire Ohio Oregon Pennsylvania South Carolina Tennessee Texas Virginia Washington Now...

Randstad USA is seeking a Program Integrity Coder- FWA Auditor to verify itemized claim reviews for payment, coding, and billing guidance. The role involves working with SIU Investigators, analyzing medical records, and abstracting codes. You will maintain current coding knowledge and provide SME support while ensuring Privacy and Security standards are met. Applicants should have 1–2 years of experience in medical record auditing, and hold an active certified coder credential. #J-18808-Ljbffr

Required Skills & Experience Certified coder (CPC, CCS, CRC, CCA, or equivalent certification) Strong ICD-10-CM coding experience and medical record review background Knowledge of Risk Adjustment and HCC coding methodologies Experience reviewing physician documentation and assigning accurate diagnosis codes Strong understanding of medical terminology, anatomy, physiology, and disease processes Ability to interpret complex clinical documentation with high accuracy and productivity Familiarity with CMS guidelines and Medicare Advantage requirements Nice to Have Skills & Experience Medicare Advantage Risk Adjustment experience Experience working with CMS-HCC models CRC (Certified Risk Adjustment Coder) certification Experience with EMRs and coding software platforms Background in a health plan, physician practice, hospital, or revenue cycle environment Audit and quality assurance experience Job Description Insight Global is seeking Medical Coders specializing in Risk...

Join The BILH TeamWhen you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.Coder PositionThe Coder position, working on the physician billing side, will be working with the Orthopedics Department at Beth Israel Deaconess Medical Center in Boston, MA. This 32-hour position has the opportunity to work remotely, with work hours occurring Monday through Friday. Candidates with CPC, RHIT, CCS, or CCS-P certification are encouraged to apply.Job DescriptionThis position is responsible for the assignment of ICD-10-CM diagnosis and procedure codes and as appropriate, CPT-4.Essential ResponsibilitiesReviews the complete electronic and paper medical record of discharged patients. Assigns ICD-10-CM diagnosis and procedure codes from documentation in the medical record, when indicated assigns CPT-4 procedure codes.Abstracts coded data and patient information into the coding abstracting system in use by BIDMC (information includes attending...

Job Description:Who We Are: The Revenue Integrity Department at the Elliot Hospital is responsible for the medical coding of our hospital and professional providers. We take pride in our work and observe best practices to ensure accurate, optimal coding. If you are a credentialed coder with strong coding skills, can work in a dynamic and changing environment, and are seeking a change, please consider Coding with our team. Apply today! About the Job: Remote Position M - F 8 am - 430 (can be flexible) - must live within the U.S. The Hospital Inpatient Coder is responsible for accurately assigning ICD-10 and DRG codes to hospital inpatient services in accordance with current coding guidelines, payer requirements, and regulatory requirements. This role supports the integrity of clinical documentation and ensures timely, compliant coding to facilitate optimal reimbursement and minimize denials. The Hospital Inpatient Coder collaborates with providers and coding leadership to...

Outpatient CoderWhen you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.Under the general supervision of the Outpatient Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing.Essential Duties & Responsibilities including but not limited to:Hospital Coding:· Review the complete electronic and scanned medical...

Fully Remote Lake Park Building Full time R183439 Job Description: The Med Grp Professional Billing (PB) Coder II is responsible for accurately resolving coding edits in assigned Epic WQ’s and assigning ICD-10, CPT, and HCPCS coding classifications and modifiers based on clinical documentation and/or physician orders. This role ensures the integrity of data for both internal and external reporting, maintains work queues within processing timeframes, responds to inquiries related to billing codes, and adheres to compliance guidelines. Essential Functions Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Assigns ICD, CPT, and HCPCS coding classifications based on clinical documentation and/or physician orders. Accurately evaluates and resolves assigned coding edits in Charge Review, Claim Edit, and Follow-up work queues in Epic within assigned timeframes. Appropriately...

Job Description:Who We Are:The Revenue Integrity Department at the Elliot Hospital is responsible for the medical coding of our hospital and professional providers. We take pride in our work and observe best practices to ensure accurate, optimal coding. If you are a credentialed coder with strong coding skills, can work in a dynamic and changing environment, and are seeking a change, please consider Coding with our team. Apply today!About the Job:Remote Position M - F 8 am - 430 (can be flexible) - must live within the U.S.The Hospital Inpatient Coder is responsible for accurately assigning ICD-10 and DRG codes to hospital inpatient services in accordance with current coding guidelines, payer requirements, and regulatory requirements. This role supports the integrity of clinical documentation and ensures timely, compliant coding to facilitate optimal reimbursement and minimize denials. The Hospital Inpatient Coder collaborates with providers and coding leadership to resolve coding...

Job Description Job Description Shift delivers AI agents that transform insurers' most critical work. By combining deep industry expertise and unmatched data resources, Shift provides proven results that have earned the trust of hundreds of the world's leading insurers. Our insurance-grade AI is accurate, explainable, and secure—empowering human experts to move with unmatched speed, total confidence, and a renewed focus on the people they serve.        Your browser does not support the video tag. Our culture is built on innovation, trust, and a drive to transform the insurance industry through our SaaS platform. We come from more than 50 different countries and cultures and together we are creating the future of insurance. Learn more at www.shift-technology.com   As part of our US Healthcare Payment Integrity and Customer Success organization, you will use your technical and clinical coding knowledge to help implement and support solutions that improve claim payment...

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Under the general supervision of the Outpatient (OP) Coding Manager and OP Coding Supervisor, the OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Job Description Essential Duties & Responsibilities including but not limited to: Hospital Coding Review the complete electronic and scanned...

Cognizant Technology Solutions Corporation is seeking an Inpatient Coder (CCS) to support one or more clients remotely. You will review medical documentation, assign ICD-10-CM diagnoses and ICD-10-PCS procedures, and query physicians to clarify documentation. This role requires CCS/RHIT/RHIA/CPC/CIC credentials, 3+ years inpatient coding, Level 1 Trauma experience, Epic experience, and a strong focus on accuracy and productivity in a fast-paced remote environment. #J-18808-Ljbffr

Certified Medical Coding Specialist Shift is the leading AI platform for insurance. Shift combines generative, agentic, and predictive AI to transform underwriting, claims, and fraud and risk - driving operational efficiency, exceptional customer experiences and measurable business impact. Trusted by the world's leading insurers, Shift delivers AI when and where it matters most, at scale and with proven results. Our culture is built on innovation, trust, and a drive to transform the insurance industry through our SaaS platform. We come from more than 50 different countries and cultures and together we are creating the future of insurance. As part of our US Healthcare Payment Integrity and Customer Success organization, you will use your technical and clinical coding knowledge to help implement and support solutions that improve claim payment accuracy. Working closely with senior specialists, product, and technical teams, you will help validate edit logic, assist with audits,...

Job Description SummaryThe Professional Surgical Coder I is responsible for the accurate and timely assignment of ICD-10-CM, CPT, and E/M codes for inpatient and outpatient services.This role reviews clinical documentation, assigns appropriate diagnoses and procedures,identifies documentation gaps, and queries providers as needed to ensure coding accuracy, compliance, and optimal reimbursement.The Professional Surgical Coder I collaborates with physicians and leadership to support documentation improvement and maintain high-quality coding standards.Job DescriptionESSENTIAL FUNCTIONS1 - Analyzes patient medical records and interprets documentation to identify all diagnoses and procedures performed. Assigns proper ICD-10CM and CPT-4 diagnostic and procedural codes to charts and related records by reference to designated coding manuals and other reference material. a - Codes 6-9 (# determined according to type of record coded) records per hour, consistently with 95% accuracy. b -...

Job Description SummaryThe Professional Surgical Coder I is responsible for the accurate and timely assignment of ICD-10-CM, CPT, and E/M codes for inpatient and outpatient services.This role reviews clinical documentation, assigns appropriate diagnoses and procedures,identifies documentation gaps, and queries providers as needed to ensure coding accuracy, compliance, and optimal reimbursement.The Professional Surgical Coder I collaborates with physicians and leadership to support documentation improvement and maintain high-quality coding standards.Job DescriptionESSENTIAL FUNCTIONS1 - Analyzes patient medical records and interprets documentation to identify all diagnoses and procedures performed. Assigns proper ICD-10CM and CPT-4 diagnostic and procedural codes to charts and related records by reference to designated coding manuals and other reference material. a - Codes 6-9 (# determined according to type of record coded) records per hour, consistently with 95% accuracy. b -...

Job Description SummaryThe Professional Surgical Coder I is responsible for the accurate and timely assignment of ICD-10-CM, CPT, and E/M codes for inpatient and outpatient services.This role reviews clinical documentation, assigns appropriate diagnoses and procedures,identifies documentation gaps, and queries providers as needed to ensure coding accuracy, compliance, and optimal reimbursement.The Professional Surgical Coder I collaborates with physicians and leadership to support documentation improvement and maintain high-quality coding standards.Job DescriptionESSENTIAL FUNCTIONS1 - Analyzes patient medical records and interprets documentation to identify all diagnoses and procedures performed. Assigns proper ICD-10CM and CPT-4 diagnostic and procedural codes to charts and related records by reference to designated coding manuals and other reference material. a - Codes 6-9 (# determined according to type of record coded) records per hour, consistently with 95% accuracy. b -...

Job Description SummaryThe Professional Surgical Coder I is responsible for the accurate and timely assignment of ICD-10-CM, CPT, and E/M codes for inpatient and outpatient services.This role reviews clinical documentation, assigns appropriate diagnoses and procedures,identifies documentation gaps, and queries providers as needed to ensure coding accuracy, compliance, and optimal reimbursement.The Professional Surgical Coder I collaborates with physicians and leadership to support documentation improvement and maintain high-quality coding standards.Job DescriptionESSENTIAL FUNCTIONS1 - Analyzes patient medical records and interprets documentation to identify all diagnoses and procedures performed. Assigns proper ICD-10CM and CPT-4 diagnostic and procedural codes to charts and related records by reference to designated coding manuals and other reference material. a - Codes 6-9 (# determined according to type of record coded) records per hour, consistently with 95% accuracy. b -...

Job Description SummaryThe Professional Surgical Coder I is responsible for the accurate and timely assignment of ICD-10-CM, CPT, and E/M codes for inpatient and outpatient services.This role reviews clinical documentation, assigns appropriate diagnoses and procedures,identifies documentation gaps, and queries providers as needed to ensure coding accuracy, compliance, and optimal reimbursement.The Professional Surgical Coder I collaborates with physicians and leadership to support documentation improvement and maintain high-quality coding standards.Job DescriptionESSENTIAL FUNCTIONS1 - Analyzes patient medical records and interprets documentation to identify all diagnoses and procedures performed. Assigns proper ICD-10CM and CPT-4 diagnostic and procedural codes to charts and related records by reference to designated coding manuals and other reference material. a - Codes 6-9 (# determined according to type of record coded) records per hour, consistently with 95% accuracy. b -...

Job Description SummaryThe Professional Surgical Coder I is responsible for the accurate and timely assignment of ICD-10-CM, CPT, and E/M codes for inpatient and outpatient services.This role reviews clinical documentation, assigns appropriate diagnoses and procedures,identifies documentation gaps, and queries providers as needed to ensure coding accuracy, compliance, and optimal reimbursement.The Professional Surgical Coder I collaborates with physicians and leadership to support documentation improvement and maintain high-quality coding standards.Job DescriptionESSENTIAL FUNCTIONS1 - Analyzes patient medical records and interprets documentation to identify all diagnoses and procedures performed. Assigns proper ICD-10CM and CPT-4 diagnostic and procedural codes to charts and related records by reference to designated coding manuals and other reference material. a - Codes 6-9 (# determined according to type of record coded) records per hour, consistently with 95% accuracy. b -...

Senior CoderWhen you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.The Senior Coder opportunity will be working with Beth Israel Deaconess Medical Center in Boston, MA. This role may have the opportunity to work fully remote.Job Description:Performs professional certified coding and provides administrative and project support to the department. Analyzes surgical-medical documentation, provides the individual surgeon/physician with the application of appropriate ICD-10/CPT/HCPCS descriptor codes including the appropriate use of modifiers to ensure compliance for reimbursement.Essential Responsibilities:Coordinates coding across various divisions. Analyzes surgical operative and other notes and documents to determine the scope and complexity of the services provided.Utilizes professional coding knowledge, applies ICD10/CPT/HCPCs codes to the services delineated in the operative note. Reviews documentation and codes to ensure...

Beth Israel Lahey Health, Inc. in Boston, MA is seeking a Senior Coder to perform professional certified coding and support the department with documentation analysis and compliance for reimbursement. The role may allow full remote work and requires CPC/CCS certifications, 3–5 years of experience, and strong Microsoft Office skills; you will collaborate with clinical staff and physicians to apply ICD-10, CPT, and HCPCS codes accurately. #J-18808-Ljbffr