10 certified irc coder jobs found in Dallas

Job Description Job Description Role Description This is a full-time on-site role for a Medical Billing Specialist. As a Medical Billing Specialist, you will play a crucial role in ensuring the financial health of our customers. We seek individuals with a strong work ethic, excellent problem-solving skills, and a genuine passion for medical billing. Your responsibilities will include managing insurance communications, reconciling insurance EOBs and payments, maintaining patient confidentiality, managing denials, utilizing ICD-10 codes, verifying insurance information, and working with commercial and government insurance providers. Due to the nature of the healthcare industry, a high degree of professionalism and attention to detail is essential.   Responsibilities Function as a subject matter expert in support of other billing team members. Demonstrate a good understanding of payer benefits requirements, claims status, submissions of claims, insurance follow-up, payment...

ESSENTIAL DUTIES AND RESPONSIBILITIES Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons. Coordinate with the Clinical Resource Center (CRC) for clinical consultations or account referrals when necessary, Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations. Follow specific payer guidelines for appeals submission Escalate exhausted appeal efforts for resolution Work payer projects as directed Research contract terms/interpretation and compile necessary supporting documentation for appeals, Terms & Conditions for Internet enabled Managed Care System (IMaCS) adjudication issues, and referral to refund unit on overpayments. Perform research and makes determination of corrective actions and takes appropriate steps to code the DCM system and route account appropriately. Escalate denial or payment variance trends to NIC leadership team for payor escalation. KNOWLEDGE,...

Job Overview Role type: Risk Adjustment Coding Auditor. Quantity of resources: 2. Duration: 6 months. JD: This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required Skills MS Suite CPC certified CRC certified 5+ years of risk adjustment experience Equal Opportunity Statement We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. #J-18808-Ljbffr

Benefit CoderThe role is responsible for execution of requests related to benefit maintenance, additions and changes across all business units within the RxClaim system.Review, analyze and handle client benefit information requests received via SalesForce.com or email. Assess completeness and accuracy of data, resolve issues based on acquired learning and tools and escalate issues on a timely basis.Ensure that individual, team-specific and site-wide metrics are achieved.Activities include but are not limited to manual coding, execution of macros and testing.Good interpersonal skillsAnalytical and fact-based decision-makerAbility to quickly identify issues and risks and provide recommendationsHigh motivational skillsExperience in team interactions and facilitationFast, enthusiastic learnerOpen to changeReceptive to feedbackTeam playerAverage communication skillsAbility to do multiple tasksDetails orientedAttention to accuracy and qualityBasic PC knowledgeAbility to prioritize1-2...

Job TitleREMOTE positionWebEx video interview will be conducted prior to an offerMUST be able to work 40 hrs/week without issueApplicant must have the necessary equipment for the contract; 2 monitors, keyboard, mouse, web camera. If not, Agency must supply ahead of start date.Knowledge and ExpertiseMust demonstrate a solid understanding of Coding Guidelines and CPT Guidelines for E/M (Evaluation and Management).Must be able to answer questions to gauge their coding knowledge.Clinic Coding ExperienceMust have experience in clinic coding, including:Office-type proceduresVaccinationsE/M levelingModifiers: Familiarity with modifiers used in the clinic setting is essential.Risk Adjustment Experience: While Risk Adjustment experience is acceptable, the candidate must also possess clinic coding experience as well.Experience in Specialty Areas: The candidate must have experience in at least five (5) of the following areas:Internal MedicineCardiologyChronic Kidney DiseaseTransplant...

Job TitleSubmission RequirementsAAPC certificate required; MUST be CPC, CPC-H and/or COC - REQUIREDMust have graduated from an approved coding program or health information management program - REQUIREDProficiency in AT LEAST 3 of the following: Specialty Clinics (Med Spec Inject, Anticoag Management, Nutrition/Oncology Nutrition, Newborn/Lactation, OP Orthotic Prosth, Urology, Apheresis, Cardiac Rehab, General Surgery, Int Pain Healing, Non Inv Cardiology, Outpatient General Surgery, Proctology, Plastic Surgery, Endocrine, Benign Gyn, Infectious Disease, Neurosurgery, Oral & Facial Surgery, Ortho Total Joint, RAD CT, RAD MRI, RAD MRI, Trauma, Amputation Clinic, Burn Clinic, Dermatology, Endocrine Surgery, ENT Clinic, GI and Liver Disease, Gyn Dysplasia, Internal Medicine, Mineral Metabolism, Ortho Foot & Ankle, Pain, Burn Outpatient, Hand Surgery, Cardiology, Comprehensive Wound, Neurology, Pulmonology Clinic, Rheumatology, Eye Clinic, Access Clinic) -...

Job Description Job Description 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...

Job Description REMOTE position WebEx video interview will be conducted prior to an offer MUST be able to work 40 hrs/week without issue Applicant must have the necessary equipment for the contract; 2 monitors, keyboard, mouse, web camera. If not, Agency must supply ahead of start date. Knowledge and Expertise: Must demonstrate a solid understanding of Coding Guidelines and CPT Guidelines for E/M (Evaluation and Management). Must be able to answer questions to gauge their coding knowledge. Clinic Coding Experience: Must have experience in clinic coding, including: Office-type procedures Vaccinations E/M leveling Modifiers: Familiarity with modifiers used in the clinic setting is essential. Risk Adjustment Experience: While Risk Adjustment experience is acceptable, the candidate must also possess clinic coding experience as well. Experience in Specialty Areas: The candidate must have experience in at...

Certified Mobile Notary Service https://certifiedmobilenotaryservice.com Responsible for validating dispute reasons following Explanation of Benefits (EOB) review, escalating payment variance trends or issues to NIC management, and generating appeals for denied or underpaid claims. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Validate denial reasons and ensures coding in DCM is accurate and reflects the denial reasons. Coordinate with the Clinical Resource Center (CRC) for clinical consultations or account referrals when necessary, Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations. Follow specific payer guidelines for appeals submission Escalate exhausted appeal efforts for resolution Work payer projects as directed Research contract terms/interpretation and compile necessary supporting documentation for appeals, Terms & Conditions for Internet enabled...

Job Title Submission Requirements AAPC certificate required; MUST be CPC, CPC-H and/or COC - REQUIRED Must have graduated from an approved coding program or health information management program - REQUIRED Proficiency in AT LEAST 3 of the following: Specialty Clinics (Med Spec Inject, Anticoag Management, Nutrition/Oncology Nutrition, Newborn/Lactation, OP Orthotic Prosth, Urology, Apheresis, Cardiac Rehab, General Surgery, Int Pain Healing, Non Inv Cardiology, Outpatient General Surgery, Proctology, Plastic Surgery, Endocrine, Benign Gyn, Infectious Disease, Neurosurgery, Oral & Facial Surgery, Ortho Total Joint, RAD CT, RAD MRI, RAD MRI, Trauma, Amputation Clinic, Burn Clinic, Dermatology, Endocrine Surgery, ENT Clinic, GI and Liver Disease, Gyn Dysplasia, Internal Medicine, Mineral Metabolism, Ortho Foot & Ankle, Pain, Burn Outpatient, Hand Surgery, Cardiology, Comprehensive Wound, Neurology, Pulmonology Clinic, Rheumatology, Eye Clinic, Access Clinic) - REQUIRED...