10 plan coder jobs found in Springfield, IL

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...

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,...

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:...

Location John H. Stroger, Jr. Hospital Department Health Information Management Shift 7:00 AM - 3:00 PM Pay Range $37.658 hourly Job Summary Under the supervision of a Coding Supervisor, the Health Information Management (HIM) Coder abstracts relevant clinical and demographic information from the medical record to identify the care rendered to the patient for the purpose of reimbursement, research and compliance. The HIM Coder ensures that the medical record reflects accurate attending physician documentation for coding of physician and facility encounters. Assigns ICD-10-CM and PCS codes, CPT-4, and HCPCS Level II codes in accordance with coding and reimbursement guidelines for physician and facility encounters. Abstracts into a group and assigns Diagnosis Related Group (DRG) on inpatient accounts and applies Ambulatory Payment Classifications (APC) to outpatient accounts. With minimal errors, identifies principal and secondary diagnosis and procedures based upon federally...

We are seeking a detail-oriented and experienced Managed Vision Care Biller to join our team in OakBrook Terrace. The ideal candidate will have a strong background in optical billing and be proficient with major vision care insurance providers including VSP, EyeMed, and Spectera. This role is essential in ensuring accurate and timely billing processes to maximize reimbursements and maintain compliance with insurance guidelines. Key Responsibilities Prepare and submit claims to managed vision care insurance providers such as VSP, EyeMed, and Spectera. Verify patient insurance eligibility and benefits prior to services. Review and process optical billing information accurately and efficiently. Follow up on unpaid or denied claims and resolve billing discrepancies. Maintain up-to-date knowledge of insurance policies, billing codes, and industry regulations. Collaborate with optical staff and insurance companies to ensure smooth billing operations. Maintain accurate records of billing...

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...

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...

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...

Job Description We are hiring for Social Compliance & Human Rights auditors. UL Solutions is seeking experienced professionals in the Northeast Region near Massachusetts, New Jersey and Connecticut to join our mission of promoting responsible sourcing and protecting human rights across global supply chains. As a Responsible Sourcing Auditor, you’ll conduct on‑site assessments at factories and facilities—helping leading brands ensure their suppliers meet labor, safety, and sustainability standards. This role goes beyond compliance—it’s a chance to influence how companies operate and improve lives around the world. You’ll be part of a forward‑thinking team that values transparency, innovation, and your expertise. Responsibilities Perform independent, high‑quality audits focused on labor practices, health and safety, and ethical sourcing. Review documentation and prepare thoroughly for each site visit. Deliver clear, professional audit reports in English—accurate, timely, and...

Department:10116 Enterprise Corporate - Administration: Medical Staff ServicesStatus:Full timeBenefits Eligible:YesHours Per Week:40Schedule Details/Additional Information:This role covers two hospital sites Condell Medical Center and Good Shepherd Hospital. It is also hybrid. 2-3 days a week in office and the rest from home.Pay Range$30.70 - $46.05Leads, plans, organizes and is responsible for the day to day operations of the Medical Staff Services Department so that all aspects of the Organized Medical Staff are supported, including credentialing activities, professional relations, meeting management, and peer review activities. Additionally, compliance is maintained, with accrediting and regulatory agencies as related to the Medical Staff, including (but not limited to) Joint Commission, DNV, HFAP, CMS, OSHA, and State and Federal Law and other standards and regulations.Major Responsibilities:Implements, coordinates, monitors, and maintains effective credentialing processes for...