21 jobs found in Richmond

Coder-Outpatient The Coder-Outpatient is responsible for the ICD-10-CM, ICD-10-PCS, CPT and modifier assignment of diagnosis and procedures of an outpatient visit. Job Specific Responsibilities: Assign and sequence diagnostic and procedural codes for patient care, utilizing ICD-10, CPT, and HCPCS coding systems. Ensure accurate and compliant coding of medical services and procedures based on clinical documentation. Review patient records and physician documentation to validate coding accuracy and completeness. Work collaboratively with healthcare providers and staff to clarify and address documentation discrepancies. Maintain knowledge of current coding guidelines, insurance regulations, and compliance standards. Assist in audits and reviews to ensure coding accuracy and adherence to billing requirements. Resolve coding errors and respond to coding-related inquiries. Protect patient confidentiality and adhere to HIPAA regulations. Education and Experience: High...

Medical Billing Specialist Neolytix is a boutique Consulting and Management Services Organization that works with small & medium-sized healthcare providers across the United States. Our portfolio of services caters to micro verticals and is built on the expertise we have developed in enabling these practices. At Neolytix, you will learn to hone your Consultative skills, develop drive & leadership, balance work with family time and importantly have fun! Medical Billing Specialist is responsible for posting medical charges, payments, and journal entries to patient accounts in a timely and accurate manner. Responsibilities include: Working directly with the insurance company, healthcare provider, and the patient to get a claim processed and paid. Verifying correct insurance filing information on behalf of the client and patient. Verifying receipt of all patient registration data from the client and notifying the client of potential coding problems. Prepare, review,...

Job Title Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.

The Medical Call Center Supervisor provides front line staff supervision, coaching, and development including hiring and training new employees, assigning tasks, and assessing performance. Supervisors will motivate, support agents through feedback and communication, and monitor key performance metrics such as inbound/outbound calls/referrals, quality, scheduled appointments, and productivity. Essential Job Statements Provides direct line supervision for multiple staff members (15-25) including scheduling (inbound/outbound calling), referral management, performance evaluations, disciplinary action, time/attendance, coordination of staff activities, or other work as needed. Conducts hiring, interviewing, onboarding, and training of new employees. Manages learning of specialty skills to ensure staff members readiness to perform independently. Works to create a diverse and inclusive culture where all team members are supported and encouraged to maximize their skills,...

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 and help us put health first 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. 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...

A leading healthcare provider in Richmond, VA is seeking a qualified individual for a role that includes performing DRG validation reviews and analyzing medical records. The ideal candidate will have RN or LPN licensure, experience with coding regulations like ICD-10, and strong Microsoft Office skills. This position offers a competitive compensation package, generous paid time off, and opportunities for career development within the organization. #J-18808-Ljbffr

Medical Call Center Supervisor The Medical Call Center Supervisor provides front line staff supervision, coaching, and development including hiring and training new employees, assigning tasks, and assessing performance. Supervisors will motivate, support agents through feedback and communication, and monitor key performance metrics such as inbound/outbound calls/referrals, quality, scheduled appointments, and productivity. Provides direct line supervision for multiple staff members (15-25) including scheduling (inbound/outbound calling), referral management, performance evaluations, disciplinary action, time/attendance, coordination of staff activities, or other work as needed. Conducts hiring, interviewing, onboarding, and training of new employees. Manages learning of specialty skills to ensure staff members readiness to perform independently. Works to create a diverse and inclusive culture where all team members are supported and encouraged to maximize their skills,...

Responsibilities Under the general direction of the Director of the Health Information Management department the Coder II (RHIA) (RHIT) (CCS) is an advanced coding position that is responsible for providing a second level review of codes assigned to medical diagnoses and clinical procedures. The coder II will be assigning diagnostic and procedure codes based on abstracted information from the medical record utilizing ICD10-CM, ICD10 PCS and CPT. Qualifications MINIMUM EDUCATION: High School Degree or equivalent required; relevant experience in lieu of High School Diploma/GED education will be considered. Associates Degree preferred. MINIMUM WORK EXPERIENCE: 2 years of experience in a hospital setting coding both inpatient and outpatient. REQUIRED LICENSES/CERTIFICATIONS: Certification in RHIA, RHIT, or CCS. REQUIRED SKILLS, KNOWLEDGE, AND ABILITIES: Ability to code utilizing ICD10-CM, ICD10 ICD10 PCS and CPT, experience with an encoder. Knowledge of...

Responsibilities One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World's Most Admired Companies by Fortune; listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. Atlantic Region CBO (uhs.com) The Atlantic Region CBO is seeking a dynamic and talented Coder. The...

We are excited to welcome a meticulous Dental Claims Medical Biller to our dynamic team. In this role, you will play a critical part in ensuring that insurance claims are processed accurately and efficiently using state-of-the-art dental billing software. If you have a background in medical or dental billing, a keen eye for detail, and thrive in a remote work environment, we want to hear from you! Key Responsibilities: Efficiently enter dental insurance claims into our billing software with precision. Conduct thorough reviews of patient records to guarantee accurate claim submissions. Confirm insurance information and eligibility as necessary to facilitate smooth processing. Proactively follow up on any unpaid or denied claims to ensure prompt reimbursement. Maintain organized and secure digital records of all billing activities. Communicate effectively with dental offices, insurance providers, and patients as needed to resolve issues. Ensure adherence to HIPAA...

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: 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...

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 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,...

Job Title: Medical Billing Specialist Location : Richmond, VA - 23235 - 100% onsite Schedule : Monday through Friday, from 8:30 am to 5 pm - 37.5 hours per week Duration/Type : Contract to Hire Job Overview: LHH Recruitment Solutions has partnered with a healthcare organization seeking a Medical Billing Specialist! In this role, you will play a crucial role in the financial health of the healthcare organization. This position is based in Richmond, VA, and requires 100% on-site presence. This is a contract to hire position based on performance. Responsibilities: • Manage accounts receivable and resolve unpaid claims • Research payer policies and submit claims appeals • Accurately post electronic or paper payments • Handle patient calls and communicate with physicians and office staff • Perform data entry and other assigned duties • Meet accuracy and volume thresholds Qualifications: • Minimum of 2 years of experience in medical...

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 role possesses...

Responsibilities One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World's Most Admired Companies by Fortune; listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. Atlantic Region CBO (uhs.com) The Atlantic Region CBO is seeking a dynamic and talented Inpatient...

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...

Remote Medical Biller (Dental Claims) We are seeking a detail-oriented Medical Biller to join our team. The primary responsibility of this role is entering and managing insurance claims using dental billing software. The ideal candidate will have prior experience in medical or dental billing, strong attention to detail, and the ability to work independently in a remote setting. Key Responsibilities: Accurately enter dental insurance claims into the billing software Review patient records to ensure accurate claim submission Verify insurance information and eligibility as needed Follow up on unpaid or denied claims to ensure timely reimbursement Maintain organized digital records of all billing activities Communicate with dental offices, insurance providers, and patients when necessary Ensure compliance with HIPAA and other billing regulations