11 diagnostic coder jobs found in Houston, TX

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case...

Senior Outpatient Coder At Houston Methodist, the Senior Outpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to day surgery and observation encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines. Qualifications Education Associate's or higher degree in a Commission on Accreditation for Health Informatics and Information Management accredited program or additional two years of experience (in addition to the minimum experience requirements listed below) in lieu of degree Experience Three years of relevant outpatient coding experience or successful completion of the Houston Methodist Senior Outpatient Coder Transition Program Licenses and Certifications Required: Must have one of the following: RHIT - Certified Health Information Technician (AHIMA) RHIA - Registered Health Information Administrator...

At Houston Methodist, the Inpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines. FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION Associate's degree or higher in a CAHIIM accredited program or additional two years of experience (in addition to the minimum experience requirements listed below) in lieu of degree EXPERIENCE One year of relevant inpatient coding experience or successful completion of the Houston Methodist Coding Apprentice Program or Outpatient to Inpatient Coder Transition Program LICENSES AND CERTIFICATIONS Required Must have one of the following: - RHIT - Certified Health Information Technician (AHIMA) - RHIA - Registered Health Information Administrator (AHIMA) - CCS - Certified Coding Specialist (AHIMA)...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Summary Responsible for reviewing clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10-CM/CPT4 codes and modifiers for billing, internal and external reporting, research, and regulatory compliance. Accurately code conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting. Typically...

About Us Harris Health System is the public healthcare safety-net provider established in 1966 to serve the residents of Harris County, Texas. As an essential healthcare system, Harris Health champions better health for the entire community, with a focus on low-income uninsured and underinsured patients, through acute and primary care, wellness, disease management and population health services. Ben Taub Hospital (Level 1 Trauma Center) and Lyndon B. Johnson Hospital (Level 3 Trauma Center) anchor Harris Health's robust network of 39 clinics, health centers, specialty locations and virtual (telemedicine) technology. Harris Health is among an elite list of health systems in the U.S. achieving Magnet® nursing excellence designation for its hospitals, the prestigious National Committee for Quality Assurance designation for its patient-centered clinics and health centers and its strong partnership with nationally recognized physician faculty, residents and researchers from Baylor...

Responsibilities HIM/Medical Records Analyst/Coding Specialist Opportunity West Oaks Hospital has provided psychiatric care to the Houston area and surrounding communities for over four decades. Our 176-bed acute care facility is fully accredited and included a 16-bed residential treatment center for adult chemical dependency. We offer a broad range of behavioral health programs for children, adolescents and adults. Treatment is offered at multiple levels of care including inpatient, partial hospitalization and intensive outpatient. We are available 24 hours a day, seven days a week to assist you and answer your questions about treatment options and insurance coverage. The hospital is easily accessible off the Southwest Freeway near the Galleria. Visit us online at: https://westoakshospital.com/ West Oaks Hospital is seeking a dynamic and talented HIM/Medical Records Coding Specialist to join our team of compassionate, dedicated professionals. The HIM/Medical...

Description: This is a hands-on role for a billing professional who can operate independently, collaborate with a small internal team, and take ownership of high-value claims. Key Responsibilities Generate and submit clean medical claims using physician-provided CPT and diagnosis codes Review and fine-tune claims prior to submission, including modifier awareness Handlefederal IDR (Independent Dispute Resolution) submissions Support appeals and follow up on denied claims when necessary Ensure claims comply with payer rules and reimbursement guidelines Work with commercial insurance carriers and Medicare Collaborate with internal billing staff on payment tracking and issue resolution Maintain accuracy, compliance, and confidentiality across all billing activities Required Experience Minimum 3 years of experience as a Medical Billing Specialist Federal IDR submission experience required Experience handling appeals and working denied claims Experience billingsurgical and procedural...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Job Description Job Description The Medical Billing Specialist is responsible for the timely and accurate submission of insurance claims, reviewing and updating denied claims for resubmission and performing reconciliations to ensure timely billing for services provided. The Medical Billing Specialist collaborates with patients, revenue cycle counterparts and work units, clinical staff, and insurance providers to drive the efficiency of the billing process and reduce the amount of denied claims. Essential Responsibilities: Reviews patient demographic and insurance information and confirms patient benefit details related to services provided by the clinic from insurance providers. Obtains necessary medical documentation from clinicians to provide to insurance companies as required for review and prior authorization of treatment. Documents authorization reference numbers in EMR and/or other systems. Updates and maintains EMR and/or other systems based on documentation...

Job Description A healthcare employer in Houston, TX is seeking a Coding Auditor to join their growing team. This position is remote but candidates must live in the following states: TX, OK, LA, TN, and GA. This position will audit and educate our coders (internal and onsite coders approx.. 40+ coders). The person in this position will audit 80-85% of the time with education to the coders based on auditing results. They will be focused on non-surgical coding within the following specialties: Urology, Bariatrics, Interventional Cardiology, OB/GYN and Neurology. They will specifically be auditing E/Ms with a heavy focus diagnosis codes and modifiers. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color,...

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...