30 cpc coder jobs found in Columbia

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for developing and conducting a variety of training programs and auditing tools for the Payment Integrity department. ***The Coder Trainer I is fully remote. Candidates will be considered nationally.*** Responsibilities: Conduct training needs analyses to determine specific training needs for Payment Integrity department staff Identify, select, and develop appropriate training programs, including the selection or design of appropriate training aids Evaluate effectiveness of training programs, including cost and benefit analyses Research, analyze and recommend external training programs Maintain records of training activities and...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58627 - MCS- University Physicians, and the department will be hiring for one position Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Work with insurance and government payers to obtain appropriate retroactive authorizations based on surgical services provided. Comply with applicable organization policies; i.e. Quality Assurance, Working Remote, Productivity, etc. Remote working options available. Shift Monday - Friday 8:00 a.m. - 5:00 p.m. OR M,Tu,W, F 7:00 a.m. - 6:00 p.m. Minimum Qualifications One of the following certifications: --Certified Coding Associate (CCA) --Certified Coding Specialist (CCS) --Registered Health Information Technician (RHIT)...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58625 - MCS-C - University Physicians, and the department will be hiring for one position Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Work with insurance and government payers to obtain appropriate retroactive authorizations based on surgical services provided. Comply with applicable organization policies; i.e. Quality Assurance, Working Remote, Productivity, etc. Remote working options available. Shift Monday - Friday 8:00 a.m. - 5:00 p.m. OR M,Tu,W, F 7:00 a.m. - 6:00 p.m. Minimum Qualifications Completion of a coding certification program or equivalent training to obtain certification using ICD-10-CM, ICD-10-PCS, and the CPT-4 coding systems. One (1)...

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines Utilize encoders and various coding resources Perform CPT Procedure reviews...

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. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate...

Job Description: The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals including governmental and/or...

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. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses...

Job Description Job Description About We are a leading physician group serving South Carolina and Georgia, dedicated to delivering quality healthcare directly to patients in care facilities, homes, clinics, and virtual visits. Our services include comprehensive primary care, specialty services, and pharmacy support, tailored to meet diverse patient needs. Committed to excellence and innovation, our team collaborates closely with facilities and families to ensure accessible, coordinated, and compassionate care. Why Choose a Career at Your Health? Providing high quality care for our patients is the center of what we do, and we provide the same care for our employees. Here are some of the benefits that are available to our employees. Competitive Compensation Package with Bonus Opportunities Employer Matched 401K Free Visit & Prescriptive Services with HDHP Insurance Plan Employer Matched HSA Generous PTO Package Career Development & Growth Opportunities...

Job Description Job Description Medical Coder W2 Contract – This will convert to a full-time role. Pay rate: $36 Location: Columbia South Carolina (on-site) - Hybrid Hours: Monday-Friday 8:00am - 4:30pm Do you have any of these certifications on your resume: RHIT, RHIA, CIC, CPMA, or CPC? If so… we want to talk to you! About the Role: Step into a key role within our healthcare organization, where you’ll help safeguard the accuracy and reliability of medical coding and billing operations. In this position, you’ll oversee detailed validation reviews across multiple business areas, drive initiatives that support cost efficiency, and uphold critical regulatory requirements including HIPAA compliance. This is an excellent opportunity to strengthen healthcare quality, support financial integrity, and expand your expertise in medical auditing and coding oversight. Responsibilities In this role, you will take the lead in performing detailed reviews of medical coding accuracy,...

Compliance Coding Auditor Hours: Variable Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No On-Call Required: No Hourly Pay Range (Minimum - Midpoint - Maximum): $48.140 - $62.110 - $76.080 The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. What You Will Do The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit...

Medical Coder Our hospital provides high-quality care that transforms the lives of those living with disabling injuries and illnesses. We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we serve. The Medical Coder reviews and assigns diagnostic and procedure codes to patient records for reimbursement and data purposes, in keeping with state and federal regulations. This position must integrate company values into daily practice. Essential Functions Include: Assigns codes using the International Classification of Disease-10th Revision-Clinical Modification (ICD-10-CM). Ensures codes are accurate and sequenced correctly in accordance with government and insurance regulations. Maintains a 95% threshold for coding accuracy. Receives and reviews patient charts and documents for accuracy. Identifies discrepancies and follows up with the provider on any documentation that is insufficient or unclear. Queries...

Inpatient Hospital Medical Coder An inpatient hospital medical coder is a healthcare professional responsible for reviewing and analyzing patient medical records from hospital stays and assigning standardized codes for diagnoses and procedures. These codes are primarily based on ICD-10-CM (International Classification of Diseases) and PCS (Procedure Coding System) standards. Responsibilities: Review clinical documentation to assign accurate ICD-10-CM and ICD-10-PCS codes. Communicate with physicians to clarify diagnoses and procedures through the query process. Utilize electronic encoder applications to assign codes in compliance with practice policies and regulatory guidelines. Maintain a minimum accuracy rate of 98% while meeting internal productivity standards. Achieve productivity expectations: Inpatient 1624 encounters per day or 23 encounters per hour. Complete reports and perform additional duties as requested by management from the hospital side of forms (not...

Outpatient Coder 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. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: 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...

Professional Medical Coder I (Remote Position, Must Reside in South Carolina) Coding Full Time AM Shift 8a-5p, Mon-Fri Sign-On Bonus: $5,000.00 Consistently named best hospital, Lexington Medical Center dedicates itself to providing quality health services that meet the needs of its communities. Ranked #1 in the Columbia metro area by U.S. News & World Report, Lexington Medical Center is the only hospital named one of the Best Places to Work in South Carolina and the first hospital in the state to achieve Magnet with Distinction status for excellence in nursing care. The 607-bed teaching hospital anchors a health care network that includes six community medical centers and employs more than 8,700 health care professionals. The network includes a cardiovascular program recognized by the American College of Cardiology as South Carolina's first HeartCARE CenterTM and an accredited Cancer Center of Excellence affiliated with MUSC Hollings Cancer Center for research and...

Remote Risk Adjustment Coder HealthCare Support is actively seeking a Remote Risk Adjustment Coder to fill an opening with a physician-centric, technology-powered healthcare management company in the state of Maryland . Daily Responsibilities For Remote Risk Adjustment Coder Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guideline Prepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditing Shift: Monday - Friday 8am ET - 5pm ET Required Qualifications For Remote Risk Adjustment Coder Must reside in the state of MD Certified Professional Coder (CPC) AND...

Internal Reference Number: R1049005 Summary We are currently hiring for a Medical Coding Specialist to join BlueCross BlueShield of South Carolina. In this role as a Medical Coding Specialist, you will review medical documentation to perform a variety of coding validations for multiple lines of business under Medicare/TRICARE to determine accuracy of billing and payment, reassign and sequence diagnostic and procedural codes using universally recognized coding system as appropriate, and compile and analyze statistics to determine focus areas for targeted medical review activities where there is the greatest potential for inappropriate Medicare/TRICARE payments.Description Location This position is full-time (40 hours/week) Monday-Friday from 8:00am-4:30pm EST and will be hybrid in Columbia, SC. What You'll Do: Determines methodology to identify cases for DRG, HIPPS, HCPCS, RUG, and APC validation. Conducts targeted coding, documentation reviews, and validation...

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 58427 - MCS - University Physicians, and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes...

Datavant is a leading data platform company dedicated to health data exchange, with a vision that every healthcare decision is powered by accurate data at the right time. Our network is one of the largest and most diverse in the U.S., ensuring that data remains secure and accessible to enhance health decisions. Our clients include prominent life sciences firms, government agencies, and healthcare providers. Joining Datavant means becoming part of a high-performing, values-driven team that is committed to solving the intricate challenges of healthcare through technological innovations. Our diverse team members bring a rich array of professional, educational, and personal experiences to support our ambitious vision for the future of healthcare. Your Role: We are seeking credentialed inpatient coders who possess meticulous attention to detail and a solid understanding of medical terminology to join our dynamic team. This position offers the flexibility of fully remote work,...

Inspire health. Serve with compassion. Be the difference. Job Summary Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of...

Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for abstracting and validating CPT, ICD-10 and HCPCS codes for inpatient, outpatient and physician's office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines. Serves as a subject matter expert for assigned specialty. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Abstracts/codes for assigned provider(s)/division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Utilizes appropriate coding software and coding resources in order to determine correct codes. Communicates billing related issues to assigned supervisor/manager and participates in meetings in order to improve overall billing, when applicable....

Medical Coding Specialist Job Details Professional Discipline : Health and Information Management Specialty : Medical Coder Employment Type : Full Time City : Columbia State : SC Pay Range : Job Description: We are seeking a detail-oriented Medical Coding Specialist to join our team. In this role, you will review medical documentation and perform coding validations across multiple lines of business under Medicare and TRICARE. Your responsibilities will include reassignment and sequencing of diagnostic and procedural codes using universally recognized coding systems, as well as compiling and analyzing data to identify areas for targeted medical review where there is a high potential for inappropriate payments. Key Responsibilities: Review and validate medical documentation for coding accuracy. Reassign and sequence diagnostic/procedural codes as appropriate. Utilize ICD-9, DRG, APC, HIPPS, HCPCS, or RUG coding systems....

Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for validating/reviewing and assigning applicable CPT, ICD-10, Modifiers and HCPCS codes for inpatient, outpatient and physicians office/clinic settings. Adheres to all coding and compliance guidelines. Maintains knowledge of coding/billing updates and payer specific coding guidelines for multi-specialty medical practice(s). Communicates with providers and team members regarding coding issues. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Validates/reviews codes for assigned provider(s)/Division(s) based on medical record documentation. Adheres to all coding and compliance guidelines. Responsible for resolving all assigned pre-billing edits Communicates billing related issues and participates in meetings to improve overall billing process...

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 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 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 guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these...