18 plan coder jobs found in Phoenix

Risk Adjustment Coding AuditorOverview We are seeking a detail-oriented Risk Adjustment Coding Auditor to support the accuracy, integrity, and compliance of clinical coding data across risk adjustment programs. In this role, you will conduct audits, review medical record documentation, identify coding opportunities, and provide guidance on coding accuracy to help support compliant reporting and appropriate reimbursement. The ideal candidate will bring extensive HCC coding and risk adjustment auditing experience, strong analytical skills, and a thorough understanding of Medicare, Medicaid, and ACA risk adjustment models. Key Responsibilities Perform retrospective and prospective chart reviews to evaluate risk adjustment diagnosis coding accuracy. Audit medical records to verify the completeness, specificity, and appropriateness of reported diagnoses. Review clinical documentation to ensure accurate HCC capture and risk adjustment reporting. Evaluate...

**Requisition number:** 2377170 **Job category:** Medical & Clinical Operations _This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges._ At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.** As the organization accelerates its digital transformation, Benefit Digitization and AI 10.0 efforts are key to improving efficiency, enhancing member and provider experiences, and managing long term costs. To achieve these goals, dedicated roles are needed to design, implement, and manage the digital capabilities that support these initiatives. This...

Sr. Clinical Coder Launch your career with Cook Systems. Since 1990, Cook Systemsa certified veteran-owned IT consulting firmhas been helping businesses and professionals grow through innovation, integrity, and investment in people. We partner with Fortune 500 enterprises and high-growth companies alike to deliver agile technology solutions, AI-driven talent strategies, and our signature FastTrack program that develops the next generation of tech talent. At Cook, you'll find a culture that values excellence, creativity, and accountability. We believe in opportunity backed by trustand in building careers that last. Check out what our team members have to say on our Glassdoor page, and discover why Cook Systems is where meaningful careers take off! Summary Under the direction of the DRG Supervisor or designee, the Medical Claims Coding Specialist conducts retrospective medical claims review for coding and pricing determinations, focusing on both outpatient and inpatient...

Job Description Job Description TTF is recruiting for an ONSITE Outpatient Coder for a well-respected healthcare organization in Central Phoenix. This is a full-time, Monday-Friday position offering a competitive salary range with the possibility of working remotely after training. Qualified candidates will have 3+ years’ experience Coding in an outpatient setting. Candidates must also have a CPC or CCS certification from AAPC.   Please send your resume to Chelle at CBodnar@ttfrecruit.com for consideration.   TTF is a search and staffing company that partners with hospitals, physician groups, TPA's, medical management companies, pharmaceutical and pharmacy benefit plan organizations, surgery centers, DME/home health, consulting companies, and all other healthcare fields. We never charge a fee to candidates and all conversations are kept confidential. We would like to be your career consultant and look forward to working with you.   The TTF Coding and HIM Division partners with...

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...

A healthcare data collaboration platform is seeking experienced inpatient coders to join their remote team. The role requires attention to detail, proficiency in medical coding, and strong communication skills. Candidates should have at least 3 years of inpatient coding experience and preferred certifications (CCS, RHIT, RHIA). The position offers a flexible schedule and includes benefits such as a 401k savings plan and comprehensive training. Pay ranges from $32 to $42 per hour based on experience and qualifications. #J-18808-Ljbffr

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:...

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. 1,500 Sign on Bonus 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,...

Medical Coder Primary City/State: Phoenix, Arizona Department Name: Coding Ambulatory Work Shift: Day Job Category: Revenue Cycle Banner Health recently earned Great Place To Work Certification. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we're constantly improving to make Banner Health the best place to work and receive care. This Coder will be supporting very busy providers/surgeons in our non-academic and academic arena. Ideal candidate would have 6 months of coding experience preferably in Oncology but someone with coding experience in the following areas can do well; ie. General Surgery, GI, Urology. Location: REMOTE, Banner provides equipment Schedule: Full time; Training 8am-5pm AZ time. Flexible scheduling after training completed. Ideal Candidate: Minimum 6 months recent experience in E/M coding (clearly reflected in your attached resume); Oncology...

Job Description Job Description   Specific Role:  Medical Biller  Reports To:  Revenue Cycle Manager  Department:  Finance  Location:  Main Admin 85048  BLS Occ:  Medical Records Specialist  (SOC 29-2072)  Salary Range:  $22.00-$28.00  Schedule:  FT M-F 8-5  Travel:  None    The Medical Biller is responsible for ensuring accurate, timely, and compliant billing for all patient encounters within a private medical practice. This role supports the revenue cycle by preparing claims, reviewing coding accuracy, resolving denials, and working closely with insurance, clinical staff, patients, and payers. The Medical Biller plays a critical role in maximizing reimbursement, reducing errors, and supporting financial stability for the practice.    Key Responsibilities  Claim Preparation & Submission  Generate and submit clean claims (electronic and paper) for all services provided by the practice  Review documentation, coding, modifiers, and charge capture for...

Atlas Healthcare Partners Job Posting Atlas Healthcare Partners exists to form strategic partnerships with health systems across the nation to develop, manage and operate Ambulatory Surgery Centers (ASCs) in their markets. As a key player in this rapidly growing healthcare segment, we are committed to providing exceptional care and outstanding customer service to every patient, every physician, every time. Our daily focus revolves around our core values of Integrity, Culture, Teamwork, Respect, and Results. In addition to fostering a workplace that encourages professional growth and advancement, we provide industry-leading health and dental benefits, paired with a matching retirement package. We look forward to you being a vital part of our journey in shaping the future of healthcare. Position Summary Evaluates medical records, provides clinical abstracts and assigns appropriate clinical diagnosis and procedure codes in accordance with nationally recognized coding...

Datavant is seeking a Profee Auditing Specialist to perform coding audits and enhance educational support related to coding quality and compliance. Candidates should have over 5 years of Professional Fee coding experience and hold a CPC certification. This fully remote role offers a competitive salary of $35—$45 per hour, alongside comprehensive benefits including medical, dental, and retirement plans. Join Datavant to contribute to transformative healthcare data solutions. #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...

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...

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...

Mission Healthcare in Phoenix, Arizona, is looking for a Medical Coder to validate and review medical coding for accuracy and compliance with regulations. Candidates should have a high school diploma, certifications as a CPC or CCS, and 3-5 years of medical coding experience. The role offers hourly pay starting at $28, along with comprehensive benefits like medical insurance and retirement plans. A focus on collaboration and inclusivity strengthens the team's culture. #J-18808-Ljbffr

Department Name: Coding Ambulatory Work Shift: Day Job Category: Revenue Cycle Innovation and highly trained staff. Banner Health recently earned Great Place to Work Certification. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Banner Health the best place to work and receive care. Looking for a motivated, experienced Trauma, GI, and/or Surgery Physician Coder to join our talented team. This position covers Trauma, Gastro and General Surgery. The ideal candidate will have at least 1 year of experience in General Surgical Coding. This position focuses on E&M (including split shared), surgeries and Critical Care coding. Location: REMOTE, Banner provides equipment Schedule: Full time; Flexible scheduling after training completed Ideal Candidates: Minimum 1 year recent experience in Gen Surg, Trauma, and/or GI coding (clearly reflected in...

Department Name: Coding-Acute Care Hospital Work Shift: Day Job Category: Revenue Cycle Estimated Pay Range: $26.40 - $44.00 / hour, based on location, education, & experience. In accordance with State Pay Transparency Rules. Banner Health recently earned Great Place To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Banner Health the best place to work and receive care. We’re looking for a motivated, experienced Inpatient Facility Acute Care Remote Medical Complex Coder to join our talented Inpatient Facility‑coding team. Candidate should have experience coding all service lines including, but not limited to: Trauma, ICU, Cardiac, Transplant, Orthopedics, High‑Risk OB, NICU, and more . This is a facility‑based coding position requiring strong PCS coding experience as well as ability to code a wide...