18 jobs found in Springfield

Become a part of our caring community and help us put health first Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor - DME Outpatient Coding on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient DME coding disputes and expertise in...

A state government agency in Illinois is seeking a Billing & Claims Support Specialist. This role involves conducting professional work in interpreting department policies and researching prior approval requests for medical services. Ideal candidates should have strong communication and problem-solving skills, with a minimum of four years of college education and related experience in medical social work. This position offers a collaborative environment focused on serving the community and providing essential healthcare support. #J-18808-Ljbffr

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...

Join Datavant, a pioneering data collaboration platform in the healthcare industry. Our mission is to secure, enhance access, and make health data actionable, providing essential data solutions for healthcare providers, health plans, researchers, and life sciences companies. Whether it involves managing patient medical records or advancing AI in healthcare, our dedicated team is actively reshaping the future of healthcare. We are in search of skilled and credentialed outpatient coders to strengthen our team. The ideal candidate should exhibit exceptional attention to detail and have a solid understanding of medical terminology. This fully remote position offers flexible work arrangements while playing a key role in transforming healthcare! Preferred Qualifications: Experience in Cath coding, Endo, Observation coding, and OP Surgery is highly desirable. Familiarity with Cerner/3M is a plus. Key Responsibilities: Review medical records and accurately assign codes for...

Join Datavant and be a part of our mission to transform healthcare through our innovative data collaboration platform. We provide essential solutions to a wide range of organizations within the healthcare ecosystem, including providers, health plans, researchers, and life sciences companies. Our team's dedication to enhancing data connectivity is paving the way for improved health outcomes. As an Inpatient Auditor Specialist, you will have a vital role in supporting our consulting and educational efforts related to coding quality, compliance assessments, and coding workflow operations. Your insights will exceed customer expectations while addressing and resolving their challenges. This is a fully remote position with a flexible schedule, allowing you to shape the future of healthcare from the comfort of your workspace! Key Responsibilities: Conduct comprehensive inpatient facility coding audits according to the specified scope of work, onboarding, focused reviews, service...

At Datavant, we're transforming healthcare by improving data collaboration. Our mission is to ensure health data is secure, accessible, and actionable. As a key player in the healthcare ecosystem, we provide crucial data solutions for providers, health plans, researchers, and life sciences companies. Whether fulfilling a single patient's medical records request or driving innovation in healthcare with AI, our dedicated team is committed to shaping the future of health data. Join our vibrant and cooperative team as a Full-Time Inpatient Coding Auditor . This fully remote role offers a flexible schedule, enabling you to make a significant impact in healthcare from the comfort of your workspace. In this position, you will play an essential role in addressing consulting and educational needs concerning coding quality, compliance assessments, external payer reviews, and more. Your Responsibilities Will Include: Conducting inpatient coding audits on medical records, ensuring...

Transform Your Career with Evolent At Evolent, we are on a mission to revolutionize health care by partnering with health plans and providers to enhance outcomes for individuals dealing with complex and costly health conditions. We strive to close the gaps in the healthcare system, ensuring that every individual receives the compassionate care that we would wish for our own loved ones. We emphasize work/life balance and offer flexibility to enable our employees to adjust their work to suit their lives. We believe the best work is accomplished in an environment that promotes personal well-being and encourages authenticity. Our commitment to diversity and inclusion is fundamental to our organization. Join us for the mission, and stay for the culture! Key Responsibilities: Work closely with SIU Investigators to support research and provide informed coding decisions. Analyze and interpret patient medical records pertinent to FWA investigations. Review claims...

A healthcare data collaboration firm is seeking experienced inpatient coders to join their fully remote team in Springfield, Illinois. The ideal candidate will have a minimum of three years of inpatient coding experience, with a strong understanding of medical terminology. Key responsibilities include assigning diagnostic codes and overseeing coding audits. The estimated hourly pay is $32 to $42. Join a team dedicated to transformative changes in healthcare. #J-18808-Ljbffr

Salary: $25.89 - $28.48 Hourly Location : Springfield, IL Job Type: Civil Service Job Number: 2401379 Department: SIU HealthCare Coding-SMS Division: Administration Opening Date: 10/02/2025 Closing Date: 3/16/2026 2:00 PM Central FLSA: Non-Exempt Bargaining Unit: Non-Represented Shift: Days ExemptorNon_Exempt: Non-Exempt We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform...

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...

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...

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...

We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform all audits based on specific departmental need. Examples of Duties PBS Auditor: 100% Conduct quality and productivity reviews of coding staff using structured and consistent review programs and methods. Demonstrate in-depth knowledge and experience with SIU-HC supported applications, including but not limited to Athena IDX, TouchWorks,...

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...

A leading health data exchange company is seeking a Remote Inpatient Auditing Specialist. The ideal candidate has a minimum of 5 years of inpatient coding experience and is proficient with MS-DRG and APR-DRG. Responsibilities include conducting coding audits and providing coder education. This role offers flexibility and the opportunity to contribute significantly to healthcare decisions. The pay range is competitive, ranging from $35 to $45 per hour. #J-18808-Ljbffr

Job Requisition ID: 54291 Opening Date: 03/12/2026 Closing Date: 03/27/2026 Agency: Teachers' Retirement System of the State of Illinois Class Title: AUDITOR - 60010 Salary: $65,577 - $102,300 Job Type: Salaried Category: Full Time County: Sangamon Number of Vacancies: 1 Merit Comp Code: Agency Excluded from Collective Bargaining Coverage Please follow the directions below when applying for this position. **DO NOT CLICK THE APPLY BUTTON** TO APPLY FOR THIS POSITION PLEASE VISIT THE TRS WEBSITE: Careers | Teachers' Retirement System of the State of Illinois The Teachers’ Retirement System of the State of Illinois (TRS) is one of the largest public pension systems in the United States. We provide retirement, disability and survivor benefits to teachers, administrators and other public-school personnel employed outside the city of Chicago. TRS serves over 456,000 members and manages a multi-billion-dollar investment portfolio for the exclusive benefit of the membership. TRS is...

Software Guidance & Assistance, Inc., (SGA), is searching for a HIM Inpatient Coder for a Contract assignment with one of our premier Healthcare clients in Chicago, IL.(% remote)Responsibilities :Assigns ICD CM-PCS and / or CPT- diagnostic and procedure codes to patient charts with accuracy and attention to detailAbstracts selected data items and enters in M encoder / Epic software with accuracy and attention to detailCompletes UHDDS data abstraction as requiredMaintains a log of work performedCompletes other assigned duties as directed by managementRequired Skills :Knowledge :RHIA, RHIT, and / or CCS CertificationMinimum years' experience Inpatient medical record codingTrauma and / or Research University ExperienceKnowledge of medical terminology and anatomy and physiology requiredWindows applications, Outlook, WebEx and other apps as needed to perform roleAbility to concentrate on task at hand in open distracting environment independent manner; minimizing distractions in...

We are seeking experienced and highly accurate Value-Based Coders to join a project dedicated to in-home health assessments for Medicare Advantage and other value-based programs.This role is 100% remote and ideal for coders who are confident working independently, detail-oriented, and committed to quality and compliance.As a contractor, you'll have the independence to manage your own schedule while contributing to meaningful work that truly makes a difference.As part of the coding team, you will review clinical documentation from in-home visits and assign complete and compliant ICD-10-CM diagnosis codes that reflect the full spectrum of each patient's health.This includes :Risk adjustment (HCC) diagnoses aligned with CMS-HCC and HHS-HCC models.Social Determinants of Health (SDOH) codes.Medication-related Z codes, such as long-term drug therapy and treatment monitoring.All other clinically relevant diagnoses supported by documentation.Your accuracy directly supports the integrity of...