37 jobs found in Madison

It's more than a career, it's a calling. WI-REMOTE Worker Type: Regular Job Summary Coordinates, organizes and prioritizes the work flow activities for the coding area. Primary Responsibilities Leads and/or coordinates shift operations, work assignments and daily priorities of assigned activities, resources, and/or associates. Serves as a leader through modeling, mentoring and training assigned staff. Manages assigned charge review and coding-related claim work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plan follow-up steps. Reviews medical record documentation in the electronic health record and/or on paper. Identifies, enters and posts CPT-4 and ICD-10 codes to the electronic health record. Identifies need for medical records from outside the organization and follows established procedures to obtain. Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or payer‑specific...

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland. Work Shift: 8 Hours - Day Shifts (United States of America) Scheduled Weekly Hours: 40 Compensation: Salary Range: $20.50 - $33.00 Union Position: No Department Details Our Coders review medical documentation, assign appropriate codes (ICD-10, HCPCS, CPT), and ensure compliance with coding standards, regulations, and company procedures. The position requires strong problem-solving skills, effective communication with medical professionals to improve documentation accuracy and the ability to work independently. We offer flexible hours and the ability to work remotely. Summary Serve as a resource for providers in understanding covered indications and the supporting documentation. Supports both technical and professional services in provider clinic as well as Ambulatory Surgery Centers...

Sanford Health is seeking a hospital coder to review medical documentation and assign ICD-10, HCPCS, and CPT codes with accuracy and independence. The role supports provider clinics, ambulatory surgery centers, and hospital services, with remote work options and flexible hours. You will ensure compliance with coding standards, participate in team meetings, and communicate guidelines to clinicians to improve documentation quality. #J-18808-Ljbffr

Medica is seeking a Compliance Program Consultant to support its compliance program through auditing and oversight of third-party vendors. This role ensures adherence to regulations and manages complex projects involving compliance documentation and regulatory inquiries. The candidate should have at least a Bachelor's degree and 3+ years experience in a related field, with strong skills in compliance, audit oversight, and communication. This is an office role, requiring presence at one of the office locations in Minnetonka, MN, or Madison, WI. #J-18808-Ljbffr

Baylor Scott & White Health in Madison, WI is seeking a Coding Auditor 1 to perform coding quality audits using ICD-10-CM/PCS, HCPCS, CPT and related references, providing feedback to coders and ensuring accurate classification. You will collaborate with Clinical Documentation Specialists, abstract data into the coding/abstracting system, and support compliant coding practices across the health system. #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. We’re looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the...

CVS Health is hiring a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU), ensuring coding accuracy and compliance across medical, behavioral health and related records. The CPC will audit CPT/HCPCS, ICD-10 and UB04 data, articulate findings to investigators and leadership, and help identify billing errors, potential fraud and opportunities for savings. This full-time role offers strong benefits and a focus on quality and integrity. #J-18808-Ljbffr

NACBA is seeking a full-time Medical Records Auditor to perform audit and abstraction of medical records to identify and submit ICD codes for CMS risk adjustment, ensuring accuracy and compliance with state and federal regulations. Responsibilities include supporting coding judgments, auditing for medical necessity, distinguishing active vs historical conditions, meeting project deadlines, and performing self-audits to align with CMS, OIG, and internal policies. #J-18808-Ljbffr

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Emplify Health, in partnership with Gundersen Health System, is seeking a detail‑oriented Coding Specialist to support accurate outpatient hospital coding and ensure compliance with ICD‑10‑CM, CPT, and HCPCS guidelines. You will review medical records, assign codes, apply modifiers, and use standard query processes to clarify clinical information, supporting accurate billing and quality data. The role involves reviewing outpatient records, following coding standards, and staying updated on #J-18808-Ljbffr

**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 and CPT 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-10 CM/CPT 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-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and...

Humana Inc. seeks a Senior Medical Coding Professional, Inpatient, to support payment integrity by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with guidelines. You will report to the Manager, Payment Integrity. You will apply ICD-10-CM/PCS coding guidelines, assess reimbursement impact, conduct retrospective audits, and collaborate with clinical reviewers and data analysts to drive accurate DRG coding and financial outcomes. #J-18808-Ljbffr

Datavant is seeking an experienced outpatient coder to join their remote team in Madison, WI. Ideal candidates have AHIMA or AAPC credentials and must demonstrate a strong understanding of medical coding guidelines and attention to detail. Responsibilities include reviewing medical records, assigning accurate codes for diagnoses and procedures, and maintaining high coding standards. Benefits include competitive pay of $20—$35 per hour, comprehensive training, and support for education and professional dues. #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Become a part of our caring community The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Where you Come In Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Position Summary The Associate Director, WW Autoimmune Cell Therapy Medical Affairs is a core member of the Worldwide Medical Affairs team and a key contributor to the development and execution of the global medical strategy across zola-cel indications in rheumatology. This individual helps shape and operationalize the worldwide medical plan with a focus on launch readiness, scientific exchange, medical education, expert engagement, advisory boards, congress strategy, medical materials, and contracting for medical affairs activities. The role supports consistent global-to-local knowledge transfer and execution while ensuring activities are aligned with the rheumatology strategy and the needs of external stakeholders. Key Responsibilities Support the development and execution of the worldwide medical affairs strategy for zola-cel across rheumatology indications Partner with regional and market medical teams to translate global strategy into actionable medical plans, ensuring...

Boone Memorial Hospital in Madison, WV is looking for a detail-oriented Coder (HIM Coder) to join the Health Information Management team. This role involves accurately coding medical records, ensuring compliance, and aiding in timely reimbursement for outpatient services. The ideal candidate will have certifications including CCS and CPC, along with robust coding experience. Strong communication skills and the ability to collaborate with various departments are key for success in this position. #J-18808-Ljbffr

Boone Memorial Hospital Inc in West Virginia is looking for a detail-oriented Coder (HIM Coder) to join the Health Information Management team. This role is crucial for ensuring accurate coding and regulatory compliance for outpatient services. The ideal candidate will have certifications like CCS, CPC, or RHIT, and at least two years of outpatient coding experience. Responsibilities include reviewing medical records, applying coding guidelines, and collaborating with providers to support high-quality documentation. #J-18808-Ljbffr

Huntsville Hospital in Madison, Alabama, is hiring for a role focused on performing internal audits of hospital accounts and managing insurance audits. This position requires effective communication with various internal departments and the ability to prioritize tasks in a fast-paced environment. The ideal candidate should have a high school diploma or GED, along with at least 3 years of experience in a clinical setting related to Patient Accounting or coding. Proficiency in Microsoft Word and Excel is essential for success in this role. #J-18808-Ljbffr

Role, Inc. is looking for a detail-oriented Insurance Billing Specialist to join their team in St. Croix Falls, WI. This full-time position offers a hybrid work schedule after training, focusing on billing medical claims to insurance and ensuring maximum payment. The ideal candidate will have 1-2 years of healthcare billing experience and strong knowledge of insurance terminology. Benefits include health and dental insurance, a 403b retirement program, and education reimbursement. #J-18808-Ljbffr

Group Health Cooperative of South Central Wisconsin is seeking a Medical Coding Specialist to ensure accurate coding and adherence to guidelines. A CPC or CCS-P certification is required, with a minimum of one year of coding experience preferred. EPIC experience is highly desirable, and the role includes supporting providers through coding education and addressing denials as needed. The position emphasizes reviewing documentation, accurate code assignment, and contributing to coding initiatives. #J-18808-Ljbffr

Medical College of Wisconsin in Milwaukee, WI is seeking an Account Rep II to submit, post, and secure maximum reimbursements from third-party carriers, government programs, and HMOs within claims submission and follow‑up. The role requires extensive use of multiple systems and coordination with payers. Hybrid work arrangement: 90% remote, 10% onsite, must reside in the metro Milwaukee area. Minimum 3 years’ experience and a high school diploma are required; EPIC experience is a plus. #J-18808-Ljbffr

Group Health Cooperative of South Central Wisconsin. BETTER TOGETHER Join our team as a Medical Coding Specialist! We are looking for a certified coding professional with strong attention to detail and a commitment to accuracy. Candidates should hold a CPC or CCS‑P certification and have completed an accredited Medical Coding Specialist Program or possess equivalent education and experience. Medical coding experience and insurance processing knowledge are preferred. The Medical Coding Specialist is responsible for reviewing electronic encounter documentation to verify that practitioner‑submitted codes are accurate, adhere to coding protocols, and comply with all applicable guidelines. This role is responsible for accurately assigning medical codes to patient records and supporting providers through education on coding and documentation requirements while contributing to coding‑related initiatives and research as needed. The position includes reviewing insurance claims to identify...