44 jobs found in Trenton

Certified Professional Coder / Bill Review Expert Responsibilities: Review medical bills related to MVA injuries sustained for NJ and or NY covered insureds Conduct reviews of medical bills and supporting documentation to ensure proper codes assigned Assign proper codes as needed based on review outcome Use various resources, IE: eBooks, 3M software to support reviews Interpret fee schedule guidelines and apply those guidelines in daily reviews Document review outcomes for customer in a professional easy to understand manner Participate in conference calls as needed with customer and/or attorneys Assist with various special projects and other duties as assigned Qualifications and Experience: 3-5 years of medical billing experience specifically NJ / NY PIP fee schedules Strong communicate skills, must be able to explain outcome of review, both written and verbally Extensive knowledge of coding /documentation requirements Thorough knowledge of CPT, HCPCs, ICD-10 CPC/AAPC...

Our client is a long-standing and well-respected non-profit healthcare organization looking for an experienced Medical Billing Specialist to join and assist their ever-growing team! Salary/Hourly Rate: 23/hr - $25/hr Position Overview: The Medical Billing Specialist will be responsible for the accurate application of all payments promptly. Candidates must be motivated and able to work in a high-volume, fast-paced environment. Medicare and Medicaid experience is needed. CPC and experience with Athena software are huge pluses. Responsibilities of the Medical Billing Specialist: Prepare and submit clean claims to various insurance companies. Research and perform all secondary billing. Ensure appropriate supporting documentation is received and completed. Review and recommend claims for adjustment/write off to management. Assis with accurate and timely processing of claims. Analyze and update claims submitted and rejected. Assist with...

Datavant is a cutting-edge data collaboration platform transforming healthcare. Our mission is to enhance the security, accessibility, and actionability of health data, benefiting a variety of organizations across the healthcare sector, including providers, health plans, researchers, and life sciences companies. By leveraging health data, we are shaping the future of patient care and health outcomes. By joining Datavant, you will become part of a driven, collaborative team dedicated to making impactful changes in the healthcare landscape. We are seeking experienced outpatient coders to be key members of our team. The ideal candidate will have meticulous attention to detail and a solid understanding of medical terminology. This role is fully remote with a flexible schedule, enabling you to contribute to the healthcare revolution from home! Preferred: Experienced PRN Outpatient Coder with a minimum of 3 years in SDS and Observation coding. Key Responsibilities: Review...

Company: Allegheny Health Network Job Description: GENERAL OVERVIEW: Join our dynamic team as a Coding Auditor Instructor, where you will play a critical role in ensuring the accuracy and compliance of coding, billing, and medical documentation. You will conduct comprehensive audits on medical records relating to DRGs, APCs, CPTs, and HCPCS Level II codes. Your expertise will help us optimize reimbursement strategies and improve data quality while adhering to regulatory requirements. ESSENTIAL RESPONSIBILITIES: Lead audits and assess the documentation, coding, and billing practices across various AHN entities. Develop and implement training programs tailored to address deficiencies discovered during audits, ensuring compliance with regulatory standards. Work closely with management on external audit findings and participate in strategic discussions to resolve issues. (20%) Create detailed audit reports to highlight coding, documentation, and financial...

Datavant is the premier data collaboration platform in healthcare. Our mission is to ensure that the world’s health data is secure, accessible, and actionable, providing vital data solutions for various healthcare organizations, including providers, health plans, researchers, and life sciences companies. At Datavant, we are revolutionizing how data is interconnected and utilized to enhance health outcomes. By joining Datavant, you will be part of a dynamic and collaborative team dedicated to effecting transformative change in the healthcare landscape. What We're Excited About: We seek a Profee Coding Lead with a solid orthopedic background, specializing in spinal procedures. The ideal candidate will efficiently monitor and report on work queue volumes, address coding queries from physicians and staff daily, and effectively communicate between the client and the coding team. Key Responsibilities: Review medical record documentation to accurately identify diagnoses...

Join our compassionate community and prioritize health! Humana invites you to apply for an exciting opportunity as an Outpatient Medical Coding Auditor focused on Durable Medical Equipment (DME) auditing. In this role, you will be an essential member of the PPI Coding Disputes Team, where your expertise in medical coding will play a pivotal role in resolving provider disputes within a results-driven environment. Become part of a Fortune 100 company that values the well-being of both its employees and consumers. As a DME Outpatient Coding Auditor, you will report to the Manager and collaborate with fellow coding professionals across various departments. Your primary goal will be to uphold the highest standards of coding accuracy, compliance, and quality. Bring your extensive experience in outpatient DME coding disputes and expertise in CPT/HCPCS code assignments. Ensure accuracy by adhering to coding guidelines and professionally communicating dispute outcomes to...

Your Future Evolves Here Evolent is dedicated to transforming health care by partnering with health plans and providers to improve outcomes for individuals with complex and high-cost health conditions. We aim to bridge the gaps in the fragmented health care system, ensuring every person receives the compassionate care we would wish for our own loved ones. At Evolent, we prioritize work/life balance and provide the flexibility to allow our employees to tailor their work to fit their lives. We believe that the best work happens in an environment that supports personal well-being and encourages authenticity. This commitment to diversity and inclusion is at the heart of our organization. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Medical Coder - FWA Auditor plays a vital role in ensuring the accuracy of complex claim reviews, coding, and billing in alignment with the Plans' provider agreements and National Healthcare...

A leading health services provider seeks an experienced professional for conducting complex audits of medical records to ensure compliance and accuracy. Candidates must possess strong knowledge of coding guidelines and a minimum of 5 years experience in documentation review and coding, with CPC or CCS-P certification required. This role offers full-time hours in New Jersey and includes competitive pay and benefits such as medical plans and 401(k). #J-18808-Ljbffr

About Atrium What you do matters. As a people‑centric organization, we foster an environment of collaboration, high performance, and innovation where your talents are valued, and your achievements are celebrated. Join us and become part of an inclusive team. Client Overview Our client is a long‑standing and well‑respected non‑profit healthcare organization looking for an experienced Medical Billing Specialist to join and assist their ever‑growing team! Salary/Hourly Rate $23/hr - $25/hr Position Overview The Medical Billing Specialist will be responsible for the accurate application of all payments promptly. Candidates must be motivated and able to work in a high‑volume, fast‑paced environment. Medicare and Medicaid experience is needed. CPC and experience with Athena software are huge pluses. Responsibilities Of The Medical Billing Specialist Prepare and submit clean claims to various insurance companies. Research and perform all secondary billing. Ensure appropriate...

I. Job Summary Under minimal supervision, plans and conducts environmental compliance audits of various entities to determine compliance with Federal and State regulatory requirements, programs and internal policies with a focus environmental regulations and capacity. II. Essential Duties and Responsibilities To perform this job successfully, an individual must be able to perform each of the following essential duties satisfactorily. Other minor duties may be assigned. Plan and conduct internal audits to determine compliance with Federal and State regulations. Review facility operations and records to ensure adequacy of internal controls, compliance with procedures, consistency with established laws, rules and regulations and guidelines applicable to overall compliance for the operation. Prepare audit reports, and implement administrative and technical audit procedures for audit program activities. Review and verify audit corrective actions and...

Job Title: Coder Location: RWJUH Hamilton Hospital Department Name: Radiation Oncology Req #: 0000234460 Status: Hourly Shift: Day Pay Range: $24.00 - $31.00 per hour Pay Transparency: The above reflects the anticipated hourly wage range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. Job Overview: The primary purpose of this position is to abstract charges and related diagnoses from radiation oncology records to ensure services billed are consistent with the record and ensure compliance with all clinical billing regulations. The coder works with faculty and staff to ensure accurate documentation of billable services. Qualifications: Required: High School Diploma CPC certified through AAPC or obtain within 6 months of employment. Preferred: ROCC-...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review. Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA or AAPC Coding Certification...

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients. Job Summary Our client is seeking a highly skilled CPC Coder responsible for reviewing medical bills and documentation to ensure accuracy and compliance with coding standards. This position involves interpreting medical documentation, assigning codes, reviewing billed services, and communicating outcomes professionally. Key Responsibilities Use various resources like CPT guidelines, CPT Assistant, Encoder Pro, and 3M Software to support reviews. Review medical bills related to Motor Vehicle Accident (MVA) injuries for NJ and NY-covered insureds. Ensure the accuracy of billed services by interpreting medical documentation and assigning the proper CPT and HCPCs codes. Review CPT codes for unbundled services and billed modifiers for accuracy. Crosswalk CPT codes per regulatory requirements for proper reimbursement. Apply fee...

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...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

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...

Join Datavant, the leading data collaboration platform in healthcare dedicated to making health data secure, accessible, and actionable. Our mission is to provide vital data solutions for healthcare organizations including providers, health plans, researchers, and life sciences companies. Contribute to the future of healthcare by enabling advanced data connectivity and transformative change. What We Are Looking For: We seek experienced and credentialed inpatient coders to join our dynamic team. If you have a keen eye for detail and a solid understanding of medical terminology, this is your chance to make a meaningful impact while enjoying the flexibility of working remotely! Your Responsibilities Include: Assigning diagnostic and procedural codes using ICD-10-CM and ICD-10-PCS. Accurately sequencing and abstracting medical codes from patient records to ensure compliance and quality. Overseeing and auditing the work of Level 1 & 2 Coders, as needed....

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...

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...

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...

Urgent Requirement - Certified Professional Coder Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow. We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity. Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right...

Remote CPC Tutor The Varsity Tutors Live Learning Platform has thousands of students looking for remote online CPC tutors. As a tutor on the Varsity Tutors Platform, you’ll have the flexibility to set your own schedule, earn competitive rates, and make a real impact on students’ learning journeys—all from the comfort of your home. Why Join Our Platform? Base contract rates start at $18/hour and increase for specialized subjects. Plus, you’ll earn incrementally higher pay for each session with the same student—reaching up to $40/hour. Get paid up to twice per week, ensuring fast and reliable compensation for the tutoring sessions you conduct and invoice. Set your own hours and tutor as much as you’d like. Tutor remotely using our purpose-built Live Learning Platform—no commuting required. Get matched with students best-suited to your teaching style and expertise. Our AI-powered Tutor Copilot enhances your sessions with real-time instructional support, lesson generation, and...

A healthcare services company is seeking a Customer Service Operations representative in Trenton, NJ. The role involves conducting outbound calls to insurance companies, handling inbound patient inquiries, and managing documentation for reimbursements. Candidates should have strong communication skills and a high school diploma with 1-3 years of relevant experience preferred. This position offers an hourly salary between $15.75 and $18.50 and includes benefits like medical coverage and paid time off. #J-18808-Ljbffr

A leading health data company is seeking experienced outpatient coders to join their remote team. Candidates must have AHIMA or AAPC certification and experience in coding within healthcare settings. The role involves reviewing medical records, assigning accurate codes, and maintaining high accuracy rates. Benefits include comprehensive training, a flexible schedule, and professional development support. This position offers a pay range of $20 - $35 per hour depending on experience and qualifications. #J-18808-Ljbffr