22 jobs found in Providence

The Revenue Compliance Auditor reports to the Director, Revenue Compliance and Education. Under general supervision, assists in executing various portions of the Brown University Health Compliance Plan. Develops and provides compliance training to employee and physician staff. Conducts retrospective audits of LifeChart documentation to assess billing, coding, patient care and compliance with Brown University Health general and specific policies and federal and state regulations. May participate in compliance investigations in those areas of risk identified by federal and state regulators. Provides a written summary of work, where problems are found makes recommendations to correct. Provides functional guidance and direction to less experienced clinical compliance audit staff. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with...

Job Summary The HIM Certified Coder reviews medical records and appropriately assigns Diagnosis and Procedure codes. Classification systems include ICD-9CM, CPT, HCPCS as well as other specialty systems as required by diagnostic category and current coding standards. All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic), ICD9 (ICD10 when applicable), AMA CPT and CMS coding guidelines. Duties & Responsibilities Reviews Patient’s records for procedures and diagnosis. Enters and maintains codes in the computer system. Planning, Productivity and Decision Making. Preserves and protects patients' rights to confidentiality. Performs other job-related duties as requested. Requirements High school graduation plus active certification as a Certified Coding Specialist (CCS) with evidence of additional education in Medical Terminology and Anatomy & Physiologie required. Certified Professional...

Outpatient Coding Specialist Reports to the Coding Manager. Reviews the outpatient clinical documentation of extract data and assign appropriate ICD-10-CM and CPT codes in accordance with the outpatient ICD-10-CM Official Guidelines for Coding and Reporting and the AHA HCPCS Coding Clinics. Reviews the medical records to ensure the documentation supports the code assignment. Utilizes 3M 360 Finder for code assignment and appropriate resolutions of claim edits (CCI, NCD, OCE, etc.) Confer with physician for clarification as needed. Monitors outpatient uncoded report to ensure timely coding and billing process. Maintains and meets HIS quality and productivity standards. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the...

The Revenue Compliance Auditor at Brown University Health supports the Director, Revenue Compliance and Education by executing portions of the compliance plan and delivering training to staff and physicians. H/ She conducts retrospective audits of LifeChart documentation to assess billing, coding, patient care, and adherence to policies, and prepares formal reports with recommendations for improvement and follow-up guidance. #J-18808-Ljbffr

Summary Brown University Health is seeking a highly motivated Full-Stack AI Developer to join a government-funded research team working at the intersection of artificial intelligence, digital health, and public health interventions. The ideal candidate will play a key role in the development and optimization of multimodal AI models, AI-driven chatbots, and agent-based modeling frameworks, contributing to research on HIV prevention, sexually transmitted infection (STI) prevention, nutrition counseling, overdose prevention, and opioid use disorder (OUD) treatment. C. A. R. E. Values Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect and Excellence, as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core...

Serco is seeking a Medical Coding Auditing Specialist to support the DHA Medical Coding Program Branch. The role covers audits across DHA markets, including MTFs and dental clinics, with potential CONUS/OCONUS travel and on-site visits. Qualified candidates have 7+ years in coding/auditing, strong CPT/ICD-CM knowledge, and a solid understanding of revenue cycle management and government coding guidelines. Documentation of education is required. #J-18808-Ljbffr

Brown University Health is seeking a highly motivated Full‑Stack AI Developer to join a government‑funded research team working at the intersection of artificial intelligence, digital health, and public health interventions. Responsibilities Design, develop and optimize multimodal AI models, AI‑based chatbots, and modify existing agent‑based modeling frameworks. Develop and maintain both front‑end and back‑end components of AI‑driven applications, ensuring seamless user experiences. Deploy and maintain AI solutions on cloud platforms (AWS, Azure, or Google Cloud) with scalable architectures. Learn and integrate public health knowledge in HIV prevention, STI prevention, nutrition counseling, and OUD treatment into AI‑based solutions. Work closely with public health experts, data scientists, and researchers to refine AI models and improve application performance. Stay updated on cutting‑edge AI technologies, including large language models, reinforcement learning, and agentic...

Brown University Health is seeking a highly motivated Full‑Stack AI Developer to join a government‑funded research team at the intersection of artificial intelligence, digital health, and public health interventions. The ideal candidate will work on multimodal AI models, AI‑driven chatbots, and agent‑based modeling frameworks for research on HIV prevention, STI prevention, nutrition counseling, overdose prevention, and opioid use disorder (OUD) treatment. Responsibilities Design, develop, and optimize multimodal AI models, AI‑based chatbots, and modify existing agent‑based modeling frameworks. Develop and maintain both front‑end and back‑end components of AI‑driven applications, ensuring seamless user experiences. Deploy and maintain AI solutions on cloud platforms (AWS, Azure, or Google Cloud) with scalable architectures. Learn and integrate public health knowledge in HIV prevention, STI prevention, nutrition counseling, and OUD treatment into AI‑based solutions. Work...

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...

Care New England is seeking a Health Information Management Certified Coder to review medical records and assign Diagnosis and Procedure codes using ICD-9CM, CPT, and HCPCS guidelines in accordance with coding standards. The role requires CCS certification with additional education in Medical Terminology and Anatomy & Physiology, and a minimum of two years’ hospital coder experience. CPC candidates may be considered but must pass CCS within one year. #J-18808-Ljbffr

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). The role ensures coding accuracy and compliance by auditing CPT/HCPCS and modifiers against medical records. You will discuss findings with investigators and regulators, identify billing errors and potential fraud, and maintain up-to-date knowledge of coding guidelines across CMS and payer requirements. #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 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...

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:...

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...

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,...

CVS Health is seeking a full‑time Medical Records Auditor to perform audit and abstraction of medical records for ICD coding used in CMS risk adjustment. You will ensure codes are accurate, well-documented, and compliant with state and federal rules. The role requires 1 year of related experience, CPC/CCS-P certification, and proficiency with ICD coding. Strong organizational skills and adherence to deadlines are essential. #J-18808-Ljbffr

Humana Inc. is seeking a Senior Medical Coding Professional, Inpatient to support payment integrity by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with official guidelines. You will report to the Manager, Payment Integrity. The role requires reviewing records, applying ICD-10-CM/PCS guidelines, and collaborating with clinical reviewers to ensure accurate reimbursement and DRG logic. #J-18808-Ljbffr

Oversee the EMT’s for the Office of Public Safety and provide support for policy and procedure development and accreditation management. Support comprehensive Emergency Management operations for the campus community. Serve as the state recognized PC EMS Service Chief and have responsibility for all Rhode Island licensed ambulance service requirements as defined by Rhode Island Department of Health (RIDOH) regulations. Attend all required RIDOH Center for Emergency Services (CEM) leadership trainings, policy meetings, compliance sessions, and related activities to ensure ongoing licensure and alignment with statewide standards. Develop and manage EMT skills instructors. Manage all course assessments, evaluations, and documentation. (40%) Ensure compliance with national and state regulations (RIDOH, CEMS), and college EMS policies and procedures governing patient care, transport decisions, and documentation for the EMT staff. Provide guidance, mentorship, and feedback that supports...

The Associate Director, Medical Publications (CNS) is responsible for supporting the implementation and execution of the global medical publication strategy and deliverables for the CNS therapeutic area. This role ensures the timely, accurate, and compliant communication of scientific and clinical data through congress abstracts, posters, manuscripts, and other peer-reviewed outputs. Working within the CNS Medical Communications team, the Associate Director partners with cross-functional stakeholders including Clinical Development, Global Integrated Evidence & Innovation (GIEI), Medical Strategy, Core Content, and external vendors to execute high-quality publication activities aligned with overall medical strategy. The Associate Director reports to the Director, Medical Publications (CNS) and plays a key role in driving operational excellence in publication execution while contributing to strategic planning and ensuring adherence to scientific and regulatory standards. Job...

Baylor Scott & White Health is seeking a Coding Auditor to perform coding quality audits, provide feedback, and ensure accurate code assignment using ICD-10-CM/PCS, HCPCS, and CPT. The role requires extensive knowledge of coding rules, HIPAA compliance, and collaboration with CDI specialists. You will abstract and validate data, support documentation improvement, and complete production coding as needed, contributing to high-quality healthcare coding outcomes. #J-18808-Ljbffr

Salary: $83,000.00 - $88,000.00 Annually Location : Providence College Job Type: Full-time Staff Job Number: PC00233 Division: Student Affairs Department: Public Safety Opening Date: 05/07/2026 FLSA: Exempt Bargaining Unit: NU Conducted under the auspices of the Dominican Friars, Providence College is a Catholic, Dominican, liberal arts institution of higher education and a community committed to academic excellence in pursuit of the truth, growth in virtue, and service of God and neighbor. We seek candidates who can affirm and contribute to our Providence College is also an equal opportunity employer and is committed to fostering a - an environment that reflects the rich diversity of the human family and is marked by justice, charity and the promotion of the common good and flourishing of all. We invite applications from qualified individuals who possess the experience, knowledge and commitment to develop the diverse learning environment envisioned as...