14 coder inpatient jobs found in Raleigh

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 a leading data platform company dedicated to health data exchange, with a vision that every healthcare decision is powered by accurate data at the right time. Our network is one of the largest and most diverse in the U.S., ensuring that data remains secure and accessible to enhance health decisions. Our clients include prominent life sciences firms, government agencies, and healthcare providers. Joining Datavant means becoming part of a high-performing, values-driven team that is committed to solving the intricate challenges of healthcare through technological innovations. Our diverse team members bring a rich array of professional, educational, and personal experiences to support our ambitious vision for the future of healthcare. Your Role: We are seeking credentialed inpatient coders who possess meticulous attention to detail and a solid understanding of medical terminology to join our dynamic team. This position offers the flexibility of fully remote work,...

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...

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Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Certified Professional Coder (CPC) Independent Contractor Remote Who We Are Constellation Quality Health is a non-profit health care quality consultancy and QIO-like Entity certified by Centers for Medicare and Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina's Research Triangle, we offer an array of quality improvement, clinical review, audit, technical, and consulting services and solutions to improve care delivery, system performance, and patient outcomes. What You'll Do The Certified Professional Coder (CPC) is responsible for reviewing and comparing provider service documentation to billed claims in order to determine compliance with clinical policies, state and federal regulations. We expect you to: Perform reviews in a manner consistent with contract requirements for timeliness and accuracy. Our requirement for this role: Associate or bachelor's degree required in a human services field or five (5) years...

Core Responsibilities Code & Abstract: Assign ICD-10-CM (diagnoses) and CPT (procedures) codes from physician documentation and medical records. Documentation Review: Evaluate records for completeness, accuracy, and compliance with coding guidelines and payer policies. Billing & Revenue Cycle: Resolve billing edits, manage charge capture, prevent denials, and ensure proper service capture for accurate reimbursement. Physician Collaboration: Educate physicians on documentation standards and work with Clinical Documentation Improvement (CDI) specialists. Data & Reporting: Ensure accurate data for DRGs, quality outcomes, internal/external reporting, and regulatory compliance. Auditing & Training: Conduct internal audits, defend coding decisions, and provide training for Coder I/II roles. Key Requirements Certifications: CPC, CCS, RHIA, RHIT, or similar are required. Experience: Varies by role (e.g., 2+ years for Coder II, 5+ years for Coder III in acute care)....

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,...

Medical Coding Coordinator 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...

Job Description About the Role: We invite you to be part of our forward-thinking healthcare information management team as a Senior Inpatient Medical Coding Specialist. This critical role will enable you to bridge the gap between clinical data and cutting-edge technology, directly contributing to the evolution of AI-driven solutions for medical coding and billing. Your extensive knowledge will play a vital role in shaping our product development strategies. Requirements and Qualifications: At least 3 years of in-depth experience in inpatient medical coding within a hospital environment. Proven expertise in accurately identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records. Thorough understanding of the evidence requirements necessary for precise coding. Hands-on experience with grouper software for MS-DRG and APR-DRG assignment. Strong communication skills for effective collaboration...

Job Description Job Description Description: Job Title : Medical Billing/Coding Specialist Type: Full Time (eligible for Benefits Package), Hourly/Non-Exempt Work Location: Raleigh, NC Office Job Overview: We are seeking a certified, detail-oriented and experienced Medical Billing and Coding Specialist to join our healthcare team. The successful candidate will be responsible for accurately translating medical procedures and diagnoses into standardized codes for billing and insurance purposes. This role requires a strong understanding of medical terminology, coding systems, and compliance with relevant regulations. Requirements: Responsibilities: Review and accurately assign medical codes to diagnoses, procedures, and services using ICD-10, CPT, and HCPCS systems. Submit clean claims to insurance companies electronically or via paper when necessary. Collaborate with healthcare providers to obtain necessary documentation for coding. Verify patient...

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...

Job Description A confidential healthcare organization in Raleigh is seeking a motivated Entry-Level Medical Coder / Billing Assistant to join their administrative team. This position offers a great pathway into the healthcare field for individuals interested in medical billing and coding. Key Responsibilities Code medical procedures accurately for billing and insurance claims. Prepare financial reports and submit claims to insurance companies or patients. Enter and maintain patient data in administrative and billing systems. Track outstanding claims and follow up on unpaid accounts. Communicate with patients to discuss balances and develop payment plans. Maintain confidentiality and comply with HIPAA and all healthcare regulations. Qualifications High school diploma or equivalent required; healthcare coursework a plus. MediClear or equivalent compliance credential required. Strong communication, organization, and time-management skills. Ability...