43 jobs found

University of Colorado Medicine (CU Medicine) is the region’s largest and most comprehensive multi-specialty physician group practice. The CU Medicine team delivers business operations, revenue cycle and administrative services to support the patients of over 4,000 University of Colorado School of Medicine physicians and advanced practice providers. These providers bring their unparalleled expertise at the forefront of medicine to deliver trusted, compassionate health care services at primary and specialty care clinics as well as facilities operated by affiliate hospitals of the University of Colorado. We are seeking a motivated Coding Education Specialist with an emphasis in Surgery experience to join our Coding Services department.    This job can be performed 100% remotely and out of state candidates will be considered. The Coding Education Specialist will primarily be responsible for supporting and leading ongoing education to existing coding staff,...

Description At CrescentCare, we bring caregivers and the community together as partners in health and wellness for all. Our experience builds on more than 40 years of impact. In 2014, we became a Federally Qualified Health Center to offer an expanded range of health and wellness services for anyone and everyone who is seeking healthcare services in Greater New Orleans and Southeastern Louisiana.   Our Mission Strengthening our entire community through whole-person healthcare and education.   Position Summary This position is responsible for managing all aspects of the revenue cycle functions for CrescentCare a Federally Qualified Health Center.  These functions include, but are not limited to, claims submissions, managing denials and rejections, coding services, payment recording, credentialing services and collections.  This position is responsible for ensuring compliance with insurance billing and coding standards (Medicare, Medicaid,...

The goal is this position is to educate providers on proper use of CPT codes, ICD10 codes,  modifiers and audit activities related to health plan operations, risk adjustment, payer audits and  regulatory requirements. This role ensures accurate medical coding, documentation integrity, and  adherence to federal, state, and payer-specific guidelines. The ideal candidate will possess  advanced CPC coding expertise, strong analytical skills, and extensive experience  supporting compliance initiatives within a managed care or health plan environment. This is a full-time position, on site, 5 days a week. Responsibilities: • Serve as subject matter expert on CPT, HCPCS, ICD10 and modifier coding for physicians  and coders. • Ensure provider documentation and coding practices comply with CMS, Medicare,  Medicaid, commercial payer, and applicable federal and state regulatory requirements.  • Conduct coding compliance audits to identify...

About Med USA Med USA is a Utah-based medical billing/provider services company with a nationwide presence. We have been in business for over 45+ years and provide practice management, payer credentialing and contracting, and full-cycle management (RCM) services, including coding, billing, follow-up, and denial resolution. Join our fast-paced, high-energy team as a medical billing specialist, with great company benefits and opportunity for growth. The ideal candidate is motivated, professional, and detail-oriented, with a strong commitment to producing high-quality work and making a positive impact on the team. If you enjoy helping others, solving problems, and working in an open, collaborative, fast-paced environment, this is a great opportunity for you. Medical billing or insurance experience is preferred, but we’re happy to train the right candidate. Position Summary The Certified Medical Coder is responsible for reviewing clinical documentation and...

JOB SUMMARY: Management and 24-hour responsibility for the planning, organizing, staffing, coordinating, and controlling of all functions of the Health Information Management Department. Serves as Livingston HealthCare’s designated Privacy Officer and is responsible for establishing, implementing, and overseeing an effective privacy program to ensure the appropriate access, use, disclosure, confidentiality, and security of protected health information and personally identifiable information. This position ensures organizational compliance with HIPAA Privacy requirements, supports HIPAA Security compliance in collaboration with the Security Officer, and promotes privacy practices consistent with state and federal regulations, Livingston HealthCare policies, and the organization’s mission, vision, values, and Code of Conduct. Schedule: 1.0FTE (40 hours) Mon-Fri 8a-5p ESSENTIAL FUNCTIONS, DUTIES, AND RESPONSIBILITIES: Prepares and...

The position audits and reports on the accuracy of procedural billing, payment consideration and accuracy in reimbursement based on the correct interpretation and application of codes, modifiers and payment rules. The incumbent reviews and audits physician and institutional billing from multiple departments and entities across the organization, and assists in training departmental personnel in correct coding and documentation. This position is not responsible for providing patient care. Responsibilities Essential Functions Performs audits and reports on the accuracy of procedure coding, facility E&M coding, ICD-10 coding and billing. Reviews insurance payments for reimbursement accuracy, which is based on correct interpretation of clinical data and application of codes, modifiers and payment rules. Reviews and audits institutional coding and billing from multiple departments and entities across the organization. Assists in training personnel in...

Medical Billing Supervisor will handle the daily operation of the billing department for a private practice with 8 providers.    Responsibilities include but are not limited to the following:  Ensure posting and collections of all billable encounters are completed in an accurate and filed in a timely manner. Manage changes in billing and coding environments as they occur through each payor source including Medicaid, Commercial, and Private Pay. Train billing and clinical staff in use of new codes Ensure that current fee schedules and billing manuals are being used for all payers billed while adhering to all organizational billing policies and procedures. Monitor, track and handle systems for billing (e.g. claim rejection) and provide detailed bi-weekly reports. Monitor aged accounts on a continuous basis working with staff to address oversights or problems within payers and patients. Ensure staff follow the process to work unpaid claims Maintain EHR user status...

Are you passionate about physician coding, compliance, and education? Gill Compliance Solutions is growing, and we're looking for an experienced Audit & Education Manager (remote) to join our nationally recognized consulting team. Our consultants work directly with physician practices, hospitals, health systems, new tech, and legal firms across the country to defend providers,  improve documentation, coding accuracy, compliance, and reimbursement. Every day presents new specialties, new challenges, and opportunities to make a measurable impact. If you enjoy educating providers, solving complex coding issues, presenting audit findings to executive leadership, and staying at the forefront of healthcare regulations, we'd love to meet you. Duties may include but are not limited to the following:      Managing and performing audits from electronic medical records initiated by a health care provider and ensures accuracy of diagnosis, procedure codes, and modifiers in...

Candidates must be able to work on-site. This position is not remote. GENERAL PURPOSE OF JOB: The Claims and Appeals Specialist II is a certified medical coder that performs audits for correct coding and claims payments and oversees the claims appeal process for provider and member appeals. This position also investigates Coordination of Benefit (COB) claims. The Claims and Appeals Specialist II reports to the Director of Claims Oversight. ESSENTIAL DUTIES AND RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate...

Position Overview We are seeking an experienced Billing Specialist to join our busy infertility practice. The ideal candidate is preferred to have billing experience in women's health care. This role requires strong knowledge of medical billing workflows, insurance follow-up, denial management, payment posting, claims resolution, and patient account management specific to women’s health. Key Responsibilities   Submit clean claims accurately and timely through our EMR system  Review and resolve claim rejections and denials across all insurance platforms  Follow up with insurance companies on unpaid claims  Post insurance and patient payments accurately in our EMR system  Work aging reports and outstanding AR  Review patient accounts for billing accuracy and follow-up needs  Handle billing corrections, resubmissions, and appeals  Communicate with registration/front desk, clinical staff, and management to resolve   billing issues  Maintain compliance with...

JOB SUMMARY:   CERTIFIED ANESTHESIA CODER   ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES   •      Review anesthesia records, operative reports, and medical documentation for completeness and accuracy. •      Ensures accurate coding, billing compliance. •      Analyzes Epic electronic medical record for assigning appropriate CPT, ICD-10-CM, HCPCS and Modifiers for anesthesia services. •      Apply appropriate anesthesia modifiers such as AA, QK, QX, QY, QZ •      Identify documentation deficiencies and communicate via EPIC query with providers for clarification.   •      Review denials, coding corrections related to anesthesia services.   •      Maintains confidentiality of patient information as per the MediSys Health Network policy. •      Meeting productivity levels of charts,60-100 anesthesia charts per day not limited to number of transactions filed or complexity of the account.   •      Reviews assigned work queues. •...

We are seeking a detail-oriented and experienced Medical Billing and Coding Specialist to join our growing team. This on-site position is ideal for a motivated professional who thrives in a fast-paced, collaborative environment while maintaining the ability to work independently. You will support multi-specialty clinics by ensuring accurate claim submission, resolving billing issues, and driving process improvements that contribute to organizational success. Key Responsibilities Review, code, and submit claims accurately and timely Manage assigned billing work queues and charge capture Investigate and resolve claim denials and rejections Analyze denial trends and recommend solutions Prepare and submit appeals with supporting documentation Utilize payer portals for claim corrections and resubmissions Collaborate with staff and providers to resolve billing issues Required Skills & Qualifications Advanced knowledge of ICD-10, CPT coding, and CMS...

About the Role: The Accounts Receivable Specialist (“Specialist”) is an integral member of Community Reach Center’s Finance (“Division”) Division. The Specialist is responsible complete billing process including timely and accurate review of the billing and reporting including data analysis and follow-up and records payments to Consumer/Patient accounts and maintains accounts receivable records. Additionally, the Specialist will have other duties and responsibilities as determined from time to time by the Accounts Receivable Manager. Essential Functions:  Conducts agency business and engages both internal and external customers in a professional and collaborative manner. Accurately post payments to account including apply notations to account for communication. Responsible for follow-up, appeals and denials of claims. Complete insurance eligibility and benefit verification. Regularly work aging and unbilled reports for payment. Reviews all intake and...

JOB SUMMARY: CDI Specialists will collaborate extensively with physicians, nursing staff, other patient caregivers, and medical records coding staff to improve the quality, specificity, accuracy and completeness of the documentation of care provided and coded. CDI Specialist will review medical records for opportunities for diagnosis clarification and validity as it pertains to DRG assignment, severity of illness, risk of mortality, and case mix data as well as timely, accurate and complete documentation of clinical information used for measuring and reporting physician and facility outcomes. These goals will be accomplished by chart review and query placement when appropriate following AHIMA guidelines and CorroHealth policies and procedures. This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:  Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended...

JOB SUMMARY: Coding Specialists are an important part of the Team at CorroHealth. Will be Coding Professional Fee charts in several specialties for clinics. Specialties needed: Trauma, Neurology/Neurosurgery, Interventional Radiology, Hospitalist, and Orthopedic This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:  Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member. This is a remote position Must live in the US. Specialties needed: Trauma,   Neurology/Neurosurgery,   and Interventional Radiology Team Member must be able to work...

This in on-site role  Job Summary The Billing Specialist II plays a key role in ensuring the success of the revenue cycle by managing billing functions, resolving denials, and supporting process improvements. This position serves as a resource for training, special projects, and complex billing issues, with a strong focus on accuracy, compliance, and timely claims resolution. Key Responsibilities: Duties include, but are not limited to: ·         Identify, research, and resolve complex claims, including payer-rejected and denied claims . ·         Investigate denial reasons and develop strategies to reduce future occurrences . ·         Prioritize and resolve items in billing and manager hold buckets . ·         Verify insurance coverage and eligibility, update patient records with accurate information . ·         Manage accounts receivable and follow up on outstanding balances . ·         Collaborate with...

About the role:                                                        The Audit and Coding Specialist (“Audit and Coding Specialist”) is an integral member of Community Reach Center’s Quality Improvement (“QI”) Division. The Audit and Coding Specialist is responsible for managing all aspects of assigned projects, reviewing compliance standards to maintain quality assurance functions, and support risk management activities for the agency. Additionally, the Audit and Coding Specialist will have other duties and responsibilities as determined from time to time by the Utilization Manager. Essential Functions:  Designs and implements internal compliance audits, regularly monitoring accuracy and adherence to documentation requirements in collaboration with Utilization Manager to support continuous quality improvement and compliance as identified in the Quality Management Plan (QMP). Conducts audits as determined by the Manager or Director. Oversees...

Cardiology and Vascular Billing Specialist Location: Port Richey, FL Position Overview We are seeking a detail-oriented   Cardiology and Vascular Authorization and Billing Specialist   to join our team in Port Richey, FL. This role is responsible for ensuring timely insurance approvals (prior authorizations) for cardiac procedures and vein treatments, while managing accurate billing, coding (ICD-10, CPT), and reimbursement processes. The ideal candidate will prevent denials by verifying benefits, providing clinical documentation to payers, and coordinating with clinical staff for peer-to-peer reviews. Key Responsibilities Prior Authorization Acquisition:   Obtain authorization for appointments, tests, and complex vascular/cardiovascular procedures by reviewing clinical documentation and understanding payor guidelines. Clinical Collaboration:   Partner with physicians to gather medical necessity documentation for insurance reviews. Billing & Coding:...

Join Our Team We are seeking a detail-oriented and experienced   Medical Billing and Coding Specialist   to join our growing team. This role is ideal for a motivated professional who thrives in a fast-paced, team-oriented environment while maintaining the ability to work independently. This is an onsite position located in Linden, NJ. This position has the ability to go remote after six months. If you enjoy solving complex billing challenges, analyzing denial trends, and contributing to process improvements, this is a great opportunity to advance your career. What You’ll Do As a key member of our revenue cycle team, you will take ownership of complex billing processes and serve as a resource for coding and payer-related issues. Core Responsibilities: Review, code, and submit provider/practice claims with accuracy and timeliness Independently manage assigned work queues to ensure proper charge capture Investigate and resolve complex claim denials and...

Director of Operations/Revenue Cycle Manager Millstone Healthcare Full-Time | In Person/Leadership Role | Physical Medicine Practice About Millstone Healthcare Millstone Healthcare is a growing multi-disciplinary physical medicine practice with over $3 million in annual revenue and a team of 35+ employees dedicated to delivering exceptional patient care. We specialize in Federal Workers Compensation, Personal Injury, & Aesthetics.  Our collaborative environment brings together providers and staff focused on improving patient outcomes while creating an efficient, positive experience for every patient we serve. We are seeking an experienced, highly organized, and results-driven  Director of Operations/Revenue Cycle Manager  to oversee the daily operations of our practice and help lead our next phase of growth. Position Summary The Director of Operations/Revenue Cycle Manager will be responsible for the overall administrative and operational...

Summary The Experienced Medical Billing Specialist provides best-in-class full RCM billing services for our private pediatric practice clients. Review claims for accuracy; oversee processing of claims to payers; resolve insurance company payments that are late, underpaid or denied; work closely with providers, practice managers and staff to implement best practice protocols. Responsibilities Learn and become proficient with the premiere pediatric system in the industry - Physician’s Computer Company (PCC) Billing. Efficiently analyze insurance claims throughout the submission process, insuring claims are accurately coded in a timely fashion, and for optimum reimbursement and compliance. Ensure that all claims reach the payers, and independently resolve any issues (underpayments, denials, etc.) with the claims so they are paid fully and on time. Post payments, organize processing of patient correspondence and statements. Answer phone inquiries from...

SCOPE/GENERAL PURPOSE OF JOB:   The Coding Specialist is responsible for abstracting all E/M, CPT, HCPCS, ICD-10-CM, modifier, and units from the medical record documentation.  Other responsibilities include accurately entering data into coding/billing software and/or Excel reports.  Performing accurate coding using applicable guidelines and facility protocols and communicating with staff and/or providers as needed.  Provide written feedback of coding results as needed in the form of comments, summary of findings, and recommendations.  Ensure compliance with federal and state laws, regulations and standards related to health information and coding principles.       ESSENTIAL DUTIES AND RESPONSIBILITIES:   Assign ICD-10 CM and CPT codes with modifiers for services provided in the facility environment (Ancillary, ED, Evaluation and Management, Observations, Outpatient surgeries, and/or Professional fee coding) depending on the specific...

Bring your coding expertise to SSM Health in a role where education, quality, and compliance come together. As a Coding Educator, you’ll partner with providers and coders, lead training initiatives, and influence documentation and coding practices that support accuracy, consistency, and revenue integrity across the organization. PRIMARY RESPONSIBILITIES Drives optimal clinical and financial outcomes through thorough assessment of provider documentation and coding competency, identification of improvement opportunities. Develops and delivers training and education of all coding processes. Stays abreast of regulatory changes and works with leadership to ensure compliance and revenue integrity. Act as subject matter expert for providers and coders while providing guidance and clarification on issues which present in their daily account processing. Establishes and coordinates internal quality review processes and corresponding training for providers and coders....

Account Specialist II Locations: Fort Worth, TX Time type: Full time Job requisition id: JR-114239 Location: Calmont Operations Building Department: CBO/Patient Financial Services Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: Under the leadership of Patient Financial Services (PFS) management, the Account Specialist II is responsible for accounts receivable through claim follow up, cash collection, and denial management for services rendered by Cook Children's Medical Center (CCMC). This position requires extensive knowledge of Federal, State, and payor regulations, reimbursement methodologies, and communication with third party payers to facilitate timely and accurate reimbursement. Perform root cause analysis and resolution of denial and variance records. Triage and resolve payor denials. Review and adjudicate insurance credit balances. Qualifications: High School Diploma or...