7 payment integrity 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...

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...

Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for leading coding teams, coder training, work que management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. 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....

This is a remote based position. Applicants can be located nationwide Back Medical Coder #2621 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who has Profee Outpatient Coding experience. We need someone who is responsible for assignment of accurate Evaluation and Management (E&M) ICD-10-CM, ICD-10- PCS, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, modifiers and quantities derived from medical record documentation (paper or electronic) for encounters dependent upon record type. Tell us about your experience with Profee Outpatient Coding. Are you a team player and a self-motivator? What is your experience with conducting business in a way that is credit to a company? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you...

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,...

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...

Job Description About the Role: We are seeking a highly skilled and experienced Senior Inpatient HIM Coder to join our dynamic healthcare information management team. This role is crucial in bridging the gap between clinical data and technology, as we aim to develop cutting-edge AI solutions for medical coding and billing processes. The successful candidate will play a pivotal role in providing valuable insights and expertise to enhance our product development efforts. Requirements and Qualifications: A minimum of 3 years of hands-on experience as an acute HIM inpatient medical coder in a hospital environment. Proficiency in identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records. In-depth understanding of supporting evidence requirements for accurate coding. Practical experience using grouper software for MS-DRG and APR-DRG assignment. Strong communication skills to interact...