29 jobs found in Madison

Inpatient Coding Auditor (PRN) Join Our Award-Winning Team and Work with the Best! We are thrilled to share that UASI has been recognized as a Top Workplace by the Cincinnati Enquirer in 2022, 2023, and 2024! With over 40 years of experience and enduring partnerships with our valued clients, we are proud of the stability we've built and the long-term success of our dedicated team. We are currently seeking an experienced facility inpatient Coding Auditor to join our team on a PRN basis. The Coding Auditor will perform inpatient coding audits and review services to client sites remotely from a home office. Additional responsibilities include: Work with clients performing coding audit and/or review services on a variety of Inpatient facility record types Identify trends based on coding audit and review findings and formulate recommendations for corrective action plans Perform necessary research to provide to the client to support findings. Examples of this research include...

Allegheny Health Network Job Posting 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...

Medical Coding Supervisor Are you a detail-oriented leader with a passion for accuracy and process improvement? Join our team as a Medical Coding Supervisor, where you'll play a key role in ensuring high-quality coding practices, supporting provider education, and leading a dedicated team that drives the success of our revenue cycle operations. The Medical Coding Supervisor oversees the operations and personnel within the Medical Coding department. Key responsibilities include reviewing provider-assigned codes for accuracy and compliance, auditing insurance claims, and addressing coding-related denials. This role provides coding education to providers, supports documentation standards, and may assist with related research initiatives. The supervisor manages team functions such as hiring, onboarding, training, performance evaluation, and ensuring adequate staffing. Additional duties include developing departmental policies, leading staff meetings, addressing inquiries or...

Evolent Health Care Job Opportunity Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. 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 the Plans' provider agreements and the National...

Vascular Surgery Coder The job family is General Coding. Travel is not required. Clearance is not required. The Vascular Surgery Coder must be proficient in surgical coding for all Trauma Surgery type cases. E/M experience is also required for associated providers. The coder will review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager, the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and...

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...

Coder I, Professional It's more than a career, it's a calling WI-Turville Bay Worker Type: Regular Job Highlights: This is a full time day shift Coder I, Professional position for SSM Health Cancer Care located at 1104 John Nolen Dr. in Madison, WI. The schedule is 8:00 a.m. to 4:30 p.m. Monday through Friday for a total of 40 hours per week. Ideal applicants will be ROCC certified (Radiation Oncology Certified Coder), have knowledge of ICD10 and CPT. Experience with pre-authorization and reviewing documentation to confirm it supports the coding is also helpful. Job Summary Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures. Job Responsibilities and Requirements Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow-up steps. Identifies all billable services. Reviews all...

Job Posting This is a remote position. Job Details: Assign diagnosis and procedure codes to reflect the condition(s) and treatment provided to the patient based on the documentation within the record for both inpatient and outpatient stays. The code assignment is utilized to determine reimbursement for the facility and physician, quality measures, hospital statistics, and medical research. Skills and Experience Required: Knowledge of the contents of the medical record Demonstrates working knowledge of ICD-10-CM, ICD-10 PCS and CPT 4. Passing Score of 80% or higher on the coding test to be considered. Working knowledge of Ambulatory Payment Classifications (APC) and Diagnostic Related Groups (DRG) Previous outpatient and/or inpatient coding experience 1 year minimum Must be a member of the AHIMA in good standing

Experienced Multi-Specialty Surgery Coder The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours: Monday - Friday, working 40 hours a week Location: Fully Remote - U.S You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provide coding and abstraction of physician or professional records Provide communications to Coordinator, Supervisors and Managers Complete RAI's, denials, charge hold reports, and coding edits Assist on special coding projects as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear...

Group Health Cooperative of South Central Wisconsin. BETTER TOGETHER Are you a detail-oriented leader with a passion for accuracy and process improvement? Join our team as a Medical Coding Supervisor , where you'll play a key role in ensuring high-quality coding practices, supporting provider education, and leading a dedicated team that drives the success of our revenue cycle operations. The Medical Coding Supervisor oversees the operations and personnel within the Medical Coding department. Key responsibilities include reviewing provider-assigned codes for accuracy and compliance, auditing insurance claims, and addressing coding-related denials. This role provides coding education to providers, supports documentation standards, and may assist with related research initiatives. The supervisor manages team functions such as hiring, onboarding, training, performance evaluation, and ensuring adequate staffing. Additional duties include developing departmental policies, leading...

Job Description Job Description Description: Illuminus is seeking a full-time Health Information Coder to join our team. The Coder is responsible for extracting relevant clinical details from patient records to assign accurate diagnostic codes (ICD-10CM) while ensuring compliance with all state and federal regulations and coding guidelines. This position will work d generally Monday - Friday from 8:00am - 4:30pm onsite at our office located at 2970 Chapel Valley Road in Fitchburg, Wisconsin. Responsibilities Maintains and actively promotes effective communication with all individuals. Maintains a positive image of the entity in the community keeping in alignment with our mission, vision, and values. Maintains working knowledge of laws, regulations, and industry guidelines that impact compliant coding while practicing ethical judgment in assigning and sequencing codes for proper reimbursement. Researches and analyzes health records to verify clinical...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures,...

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...

Company: Allegheny Health Network Job Description: GENERAL OVERVIEW: This role involves comprehensive medical record reviews to extract vital medical and demographic data, accurately interpret and apply diagnoses and procedures using ICD coding systems, and contribute to reducing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES: Thoroughly review and interpret medical records, physician treatment plans, outcomes, and other relevant information to assign appropriate ICD codes for diagnoses and procedures. (65%) Abstract necessary data elements to fulfill statistical requests from the hospital, health system, and medical staff, ensuring all coded and abstracted information is accurately input into the designated system. (15%) Manage medical information efficiently and support cash flow by monitoring and addressing the unbilled coding report. (10%) Stay updated on ICD guidelines by participating in training, reviewing coding clinics,...

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...

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...

Join Datavant, a leading data platform company revolutionizing health data exchange. Our mission ensures that every healthcare decision is guided by the right data at the right time and in the right format. As the world's foremost health data network, our platform enables secure, accessible, and actionable data, empowering healthcare stakeholders including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing, values-driven team, you'll contribute to innovative technology solutions that address some of healthcare's most challenging issues. Our diverse team brings various professional, educational, and life experiences together to achieve our ambitious goals for the healthcare sector. What You'll Be Doing: Conduct audits of coded medical charts according to the client's guidelines as assigned by the quality supervisor. Navigate multiple client guidelines with ease. Maintain a 95% quality average at the...

Datavant is a leading data platform company specializing in health data exchange, dedicated to empowering healthcare decisions with timely and accurate data. We harness the power of the largest health data network in the U.S. to ensure data is secure and effectively used to enhance health outcomes. Joining Datavant means becoming a vital part of a high-performing, values-driven team that is addressing complex healthcare challenges with innovative solutions. Our team members come from diverse professional, educational, and personal backgrounds to pursue our ambitious vision for healthcare. We are actively seeking skilled and credentialed outpatient coders to enhance our team. The ideal candidate will demonstrate exceptional attention to detail and possess a profound understanding of medical terminology. This remote position offers flexibility, allowing you to contribute significantly to the future of healthcare from your own home! What You Will Do: Review medical records...

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...

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. (60%) 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...

SPECIALTY SCOPE FOR THIS CODER II POSITION TO INCLUDE BUT NOT LIMITED TO: Upper Extremity: - Shoulders: Total/Hemi Arthroplasty, Arthroscopy, Rotator cuff repair, Biceps tenodesis, Acromioplasty, Distal claviculectomy, Superior Labrum Anterior to Posterior tear (SLAP) repair - Elbows: Cubital tunnel release, Bursectomy, Arthroplasty - Wrist: Carpal tunnel release, Carpectomy, TFCC debridement/repair, 4-corner fusion, De Quervain (1st dorsal compartment) - Hands: Trigger fingers, Ganglions, Mallet fingers, Carpometacarpal (CMC) arthroplasty, , Dupuytren's (Palmar fascial fibromatosis), Amputations Lower Extremity: - Hips: Dislocation reductions, Total/partial Arthroplasty, Femoral fracture treatments, Arthroscopy - Pelvis: Fracture repairs - Femur: ORIF neck fractures, Trochanteric repairs, shaft fracture repairs - Knees: Dislocation repairs/reductions, Total/hemi arthroplasty, Meniscal repairs, Ligamentous reconstructions and repairs,...

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 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...

It's more than a career, it's a calling WI-Turville Bay Worker Type: Regular Job Highlights: This is a full time day shift Coder I, Professional position for SSM Health Cancer Care located at 1104 John Nolen Dr. in Madison, WI. The schedule is 8:00 a.m. to 4:30 p.m. Monday through Friday for a total of 40 hours per week. Ideal applicants will be ROCC certified (Radiation Oncology Certified Coder), have knowledge of ICD10 and CPT. Experience with pre-authorization and reviewing documentation to confirm it supports the coding is also helpful. Job Summary: Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow-up steps. Identifies...