16 coder analyst jobs found in Washington

Job Description Job Description Mb Staffing Services is seeking a detail-oriented Medicaid Coding & Reimbursement Analyst with direct experience in Medicaid billing, coding, claims review, and financial reconciliation. This role is ideal for professionals who understand the financial side of healthcare operations and are passionate about accuracy, compliance, and reporting. Key Responsibilities Review and analyze Medicaid claims, billing, and reimbursement data. Perform data entry and validate coding information for accuracy. Utilize ICD-10, CPT, HCPCS, and Medicaid-specific codes. Reconcile reports, payments, and billing discrepancies. Research and resolve claim denials and coding issues. Conduct audits and support compliance initiatives. Generate reports and analyze trends to improve billing accuracy. Review financial and operational data to identify variances and opportunities for improvement. Collaborate with providers and internal teams to ensure timely...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Ankura is a team of excellence founded on innovation and growth.**Practice Overview:**Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Job Description Job Description Neurology Services, Inc., is looking to hire a full-time Medical Billing Specialist . The Medical Billing Specialist is responsible for posting charges and receipt of payment for all medical services rendered by Neurology Services, Inc. In this role you are held accountable for the management of the accounts, throughout the entire collections process. Prompt submission and follow-up of all claims are essential for success. Persistency is vital! Errors will result in slow payment and/or reduced and lost revenue. You will be supporting the founder and owner of Neurology Services, Inc., Dr. Peter Bernad, who offers effective and individualized treatments to correct a host of medical conditions. He is a board-certified physician and has broad experience in pediatric, medical and surgical care. The practice does not perform surgery but focuses on determining the basis or cause of a patient’s problem. We treat patients with a wide variety of...

Job Description Job Description Job Title: Coding Specialist-New Jersey Ave. Location: Washington, DC Organization: Unity Health Care Employment Type: Full-Time About Unity Health Care Unity Health Care is a mission-driven, federally qualified health center committed to providing high-quality, compassionate, and comprehensive health care services to underserved communities throughout Washington, DC. Our team is dedicated to improving health outcomes through accessible, patient-centered care while supporting excellence in clinical operations and revenue cycle management. Position Summary Under the supervision of the Medical Billing Coding Manager, the Coding Specialist plays a critical role in ensuring accurate medical coding, charge capture, and reimbursement for healthcare services. This position reviews medical documentation, assigns appropriate diagnosis and procedure codes, supports compliance with federal and payer regulations, and helps maintain the integrity of the...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach Partner with clinical and...

A leading consulting firm seeks a Sr. Associate to join its Health Care team in Washington, D.C. This position involves coding, compliance analysis, and project management for investigations and disputes in the health care sector. Ideal candidates will possess strong clinical knowledge and a CRC certification, with at least five years of relevant experience. The role allows for remote work and requires excellent communication skills. Salary range is between $85,000 and $200,000, commensurate with experience and other factors. #J-18808-Ljbffr

Become a part of our caring community The Medical Coder / Coding Educator 2 identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. Will report to the Manager, Medicare Risk Adjustment As the Medical Coder / Coding Educator 2 you will Arrange educational sessions with assigned providers aimed at quality of care and documentation improvements. Identify educational needs based on reports Prepare comprehensive reports and presentations on coding quality trends, risk areas, and educational outcomes using data visualization techniques. Provider onsite education, based on business needs Collaboration with other market provider facing role Use data analytics tools to assess coding quality, identify error patterns, and monitor compliance with internal and external standards. Analyze coding audit results and other relevant data to develop data-driven educational materials and...

About Integrated Management Strategies (IMS) LLC We area women-owned small business and management consulting firm that provides an array of business and technical services. IMS is headquartered inthe Washington, D.C. metropolitan area, with employees across 39 US states. What We Do We support the mission critical needs of federal agencies and commercial businesses by leveraging our experience, talent and can-do attitude, and solve their strategic and operational challenges. How We Do It We earn our clients’ trust through our personalized approach and attention to detail, allowing us to collaborate and solve even the most complex problems. About the role Are you ready for your next career adventure?! Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Medical Coder to join our healthcare consulting practice. The...

Humana Inc in Washington, D.C. is seeking a Senior Market Consultation / Partnership Professional to enhance the quality of risk adjustment programs by ensuring accurate coding practices. This role involves complex issues requiring analysis of clinical documentation and coding accuracy. Applicants should have an active RN license or equivalent, alongside certifications as a Professional Coder. The position promotes collaboration with clinical teams and physician groups to improve documentation standards. #J-18808-Ljbffr

Overview Better Morning emerged as an outpatient behavioral health practice in Ashburn, VA in 2014. In addition to providing counseling from the Ashburn office, Better Morning started as a certified provider for intensive in-home and community-based services (IHCBS) for at‑risk youth in the District of Columbia. In August 2017, Better Morning was certified as a Core Service Agency (CSA) by the DC Department of Behavioral Health. The founder's passion for at‑risk youth and their families motivated the expansion of evidenced‑based programs to serve underserved populations. Job Description The Medicaid & MCO Biller is responsible for accurate and timely submission, tracking, and reconciliation of claims for services billed to DC Medicaid and Managed Care Organizations (MCOs). This role ensures compliance with District of Columbia Department of Health Care Finance (DHCF) regulations and payer-specific billing requirements while supporting revenue cycle efficiency....

A health care advisory firm is seeking a Sr. Associate to analyze medical records and ensure compliance with coding standards. The ideal candidate will be certified in Risk Adjustment Coding and have at least five years of experience in HCC/Risk Adjustment methodologies. Strong communication skills and proficiency in Excel are essential. This role offers a hybrid work environment. Salary range is between $85,000 to $200,000 based on qualifications and experience. #J-18808-Ljbffr

Medical Biller (Medicaid & MCO - Behavioral Health) The Medicaid & MCO Biller is responsible for accurate and timely submission, tracking, and reconciliation of claims for services billed to DC Medicaid and Managed Care Organizations (MCOs). This role ensures compliance with District of Columbia Department of Health Care Finance regulations and payer‑specific billing requirements while supporting revenue cycle efficiency. Eligibility & Authorization Verification Verify Medicaid eligibility using systems such as DC Access System or other payer portals. Confirm MCO enrollment and service coverage prior to claim submission. Track and manage prior authorizations and limitations. Claims Submission & Processing Submit clean claims to DC Medicaid and MCOs (e.g., AmeriHealth Caritas DC, MedStar Family Choice DC, Wellpoint, HSCSN). Ensure proper use of CPT, HCPCS, and ICD-10 codes for behavioral health services. Verify authorization requirements prior to billing...

Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura’s Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving research...

Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura's Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving research...