40 jobs found in Raleigh

Job Description: The Air Medical Coding Coordinator Codes Air Medical outpatient billing for government and private payers. The Air Medical Coding Coordinator reviews patient transport records and assigns CPT and ICD 10 codes in compliance with payer guidelines. This position completes post-service audits and works with providers and other internal departments to ensure accurate assignment of charges and timely billing for the Emergent, Air Medical Charter and Donor Services programs. This position works with providers, payers, hospital case managers and Medical Transport leadership to approve and collect for the medical transport system. This position completes, daily, weekly and monthly analytics for the Medical Transport Service line. Serves as team experts in working with revenue cycle, finance, and payer contracting to ensure accuracy and expertise in correct reimbursement. Serves as the coding expert and educates internal clinical staff in documentation and appropriate...

A leading health insurance company is seeking an Inpatient Medical Coding Auditor to work remotely. This role involves reviewing inpatient hospital claims and ensuring accurate coding and reimbursement. Candidates should hold an RHIA, RHIT, or CCS certification with substantial experience in coding audits. Strong attention to detail, excellent communication skills, and the ability to manage multiple priorities are essential. The job offers competitive compensation and various benefits to support overall well-being. #J-18808-Ljbffr

A healthcare data solutions provider is seeking an Inpatient Auditing Specialist who will perform audits on medical records and ensure compliance with DRGs. This fully remote role requires 3+ years of coding and auditing experience and offers a flexible schedule. Responsibilities include conducting audits, providing education, and maintaining communication with healthcare staff concerning clinical issues. Competitive salary and generous benefits are included in the role's compensation package. #J-18808-Ljbffr

A healthcare organization seeks an Oncology Data Specialist for remote work focusing on cancer data abstraction and coding. The role requires a minimum of one year in a Cancer Registry position, adaptability to a changing work environment, and knowledge of coding in cancer registry software such as EPIC and CRStar. Ideal candidates will possess an Associate or Bachelor degree in an accredited program. #J-18808-Ljbffr

Become a part of our caring community 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, processes and techniques, and...

Woven Health Collective is seeking an Account Supervisor I to oversee day-to-day operations of medical communications accounts. This role serves as the primary client contact, managing multiple projects, ensuring high-quality delivery and mentoring junior staff. Ideal candidates have 4-6 years of account management experience in healthcare marketing, strong communication skills, and a solid understanding of project and account budgets. Join us in revolutionizing healthcare through innovation and collaboration. #J-18808-Ljbffr

Job Title Physician Coder I Overview The Physician Coder I has a background in and experience with coding inpatient and outpatient Evaluation and Management (E/M) services, bedside and/or clinic procedures, and ancillary procedures/testing for all specialties within WakeMed. Strong interpersonal and communication skills are required to ensure timely identification and resolution of coding-related issues. The Physician Coder I will complete tasks in accordance with designated assignments and will be subject to productivity and quality reviews. Department Description Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org. EOE Licensure Certified Coding Specialist Or Certified Professional Coder Or Certified Outpatient Coder...

Overview Serves as the senior member of the corporate coding team by providing extensive knowledge for timely and accurate coding and DRG assignment. Performs the function of coding, DRG assignment, collection of predefined indicators, and abstracting medical records. Provides timely and accurate ICD-10-CM and ICD-10-PCS codes for reimbursement and specific information for statistical purposes. Serves as a liaison between coders and CDS team on coding and documentation issues. Reviews SMART accounts on a daily basis as assigned. **Eligible remote states include NC, FL, GA, SC, SD, TN, TX and VA.** Department Description Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org. EOE Licensure Registered Health...

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. 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 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...

Become a part of our caring community The Medical Coder 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 Medical Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates databases. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. 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 correct...

Medical Science Liaison At Lilly, we unite caring with discovery to make life better for people around the world. We are a global healthcare leader headquartered in Indianapolis, Indiana. Our employees around the world work to discover and bring life-changing medicines to those who need them, improve the understanding and management of disease, and give back to our communities through philanthropy and volunteerism. We give our best effort to our work, and we put people first. Organization Overview: At Lilly, we serve an extraordinary purpose. We make a difference for people around the globe by discovering, developing and delivering medicines that help them live longer, healthier, more active lives. Not only do we deliver breakthrough medications, but you also can count on us to develop creative solutions to support communities through philanthropy and volunteerism. Purpose: Scientific and Clinical Experts (SEs/CEs) are individuals who are noted for their expertise in a...

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 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 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 guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these...

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...

Ultimate Staffing is seeking a Medical Biller in Raleigh (North Hills area). THIS POSITION WILL REQUIRE ON SITE PRESENCE. Hours: Monday - Friday, 8am to 5pm Specific experience with handling Denied and/or Rejected claims required. Pay rate $18-$22 per hour depending on experience. Job Duties: Perform completion of claims to payers Conduct duties in a professional and timely fashion Submit billing data to the appropriate insurance providers Process claims Resolve denial instances Achieve maximum reimbursement for services provided Deploy, maintain and report on various programs Do Medicare reviews Do Medi-Cal reviews Conduct audits Requirements: Minimum two years Medical Billing/ Medical Claims experience Denied and Rejected Claims experience is a must Strong knowledge of BCBS All qualified applicants will receive...

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:...

Baylor Scott & White Health is seeking a Physician Compliance Auditor II located in Raleigh, North Carolina. The role involves auditing compliance activities, providing recommendations, and ensuring documentation meets standards across multiple specialties. Candidates should have four years of experience, active coding certification, and a Bachelor's degree. The position is remote and offers a pay range of $26.66 to $40.00 based on experience. Join a diverse workforce dedicated to improving health outcomes. #J-18808-Ljbffr

Humana Inc. is seeking a Supervisor, Medical Coding to oversee the coding disputes team and implement process improvements. This remote position requires a minimum of 6 years of medical coding experience and at least 2 years of leadership experience. The successful candidate will collaborate with management to ensure consistent operations and focus on improving consumer experiences. The role offers competitive benefits and a salary range of $71,100 - $97,800 per year, along with opportunities for bonuses and professional development. #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. Core Values 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: Benefits may vary based upon position type and/or level. Job Summary The...

BlueCross BlueShield of South Carolina is looking for a qualified candidate for a remote position performing validation reviews of medical records and coordinating rate adjustments. The ideal applicant will have at least 3 years of medical record management experience and hold relevant certifications. Benefits include subsidized health plans, a 401(k) plan, and paid time off, fostering a diverse and inclusive workplace for all employees. #J-18808-Ljbffr

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 for...

A leading health data platform company is seeking experienced inpatient coders to join their team. This role requires a minimum of 3 years of inpatient coding experience along with strong knowledge of medical terminology. The position is fully remote, allowing for a flexible schedule. The ideal candidate will excel in coding accuracy, maintain communication with team members, and support documentation improvement initiatives. #J-18808-Ljbffr

Overview BlueCross BlueShield of South Carolina is a leading national insurance company that has served the South Carolina community for more than seventy years. We are the largest insurance company in South Carolina, a leading administrator of government contracts, and operate one of the most sophisticated data processing centers in the Southeast. With a diverse family of subsidiary companies we deliver outstanding service to our customers and build on diverse business strengths. Position Purpose Performs validation reviews of Diagnosis Related Groups (DRG), Adaptive Predictive Coding (APC), and Never Events (serious, preventable medical errors) for all lines of business. Coordinates rate adjustments with claims areas. Provides monthly and quarterly reports outlining trends. Serves as a resource in resolving coding issues. Coordinates HIPAA and legal records requests for all areas of Healthcare Services and the Legal Department. Location This is a remote position, Monday -...

Ultimate Staffing - - Responsibilities: Perform completion of claims to payers; Submit billing data to the appropriate insurance providers; Process claims; Resolve denial instances; Deploy, maintain and report on various programs

Veradigm is seeking an RCS Medical Coding Auditor in Raleigh, NC, to audit professional medical coding. This role requires strong experience with ProFee coding and deep knowledge of relevant guidelines. Ideal candidates will demonstrate excellent communication and analytical skills. Responsibilities include conducting audits, providing education, and ensuring compliance. The position offers a salary range of $57,728-$80,243 and a comprehensive benefits package. #J-18808-Ljbffr