35 clinical coder jobs found

Accountable for conversion of outpatient diagnoses and treatment procedures into codes using an international classification of diseases, and HCPCS codes based on documentation in the patient’s record, are coded accurately and in a timely manner. Complies with government, insurance regulations and with medical coding guidelines and polices that all records are coded accurately and in a timely manner. CORE FUNCTIONS 1. Reviews and validates all diagnoses/procedures stated by physician and other healthcare providers. Ensures that records are coded within 48 business hours of discharge. Notifies director whenever work is more than 48 hours behind work deadline. Meets productivity standard of assigning codes to a minimum of 25 charts per hour. 2. Partners with charting physician if diagnosis is not transcribed to assure all required documentation is presented to meet compliance accuracy in coding and severity of illness is charted and coded. 3. Codes diagnoses and...

The Provider Education Auditor works collaboratively with physicians, other healthcare professionals and coding staff to ensure that clinical information in the medical record is present and accurate so that the appropriate utilization, clinical severity, outcomes and quality is captured for the level of service rendered to all patients, as well as ensuring compliant reimbursement of patient care services. Responsibilities: Responsible for reviewing and analyzing all aspects of the department clinical documentation and care to ensure timely, accurate, and compliant charge capture and submission Works as an educational resource to inform and educate departments on the latest government regulation and requirements, including CMS, the State, and payer regulations related to these charges Collaborates with Coding Supervisor and Regional Medical director to ensure clinical documentation in high-risk areas is consistent and complete Duties include charge entry, ensuring...

The Senior Medical Director serves as a pivotal clinical leader within Lyric, providing strategic oversight for the development, validation, and continuous improvement of pre-payment edits to ensure robust payment integrity. In this capacity, the Senior Medical Director partners with executive leadership, clinical teams, and external stakeholders, acting as a trusted advisor on complex clinical scenarios and claims outcomes. As the primary liaison between Lyric and its customers, this role represents the organization in industry forums and payer-provider collaborations, fostering strong relationships and advancing Lyric’s reputation as an industry leader. The Senior Medical Director is also responsible for remaining at the forefront of evolving healthcare trends, regulatory requirements, and advancements in medical practice, ensuring that Lyric’s strategies and solutions consistently reflect best practices and support organizational objectives. Role Responsibilities:...

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary: We are seeking a talented individual for a Clinical DRG Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to validate the conditions that were documented in the medical record, the ICD-10-CM/PCS code assignments and determine the accuracy of DRG assignment that is clinically supported as defined by review methodologies specific to the...

The University of Missouri School of Medicine is seeking an experienced and strategic Supervisor, Coding & Data Management to lead our Professional Coding and Revenue team. This role is critical to ensuring accurate medical coding that directly translates into clinical revenue integrity, regulatory compliance, and operational excellence. If you are a certified coding professional who thrives in leadership, process improvement, and complex reimbursement environments, we invite you to apply. Why Join Us? At the School of Medicine, our coding leadership team plays a vital role in supporting clinical operations, optimizing reimbursement, and maintaining compliance with federal and commercial payer regulations. You will collaborate with physicians, administrators, and revenue cycle professionals in a mission-driven academic healthcare setting. Position Overview The Supervisor, Coding & Data Management is responsible for overseeing coding accuracy, reimbursement...

SCOPE: Under minimal supervision performs periodic, comprehensive coding audits for all assigned regional oncologists (medical, radiation and surgical oncology).   Verifies charge documentation and charge submission processes are in compliance with Federal and State regulations, as well as payer guidelines. Coordinates efforts with manager and front office managers to ensure optimal revenue cycle processes and adherence to compliance and revenue cycle policies and procedures.  Provides effective educational feedback to physicians and staff on findings from audits and updates in Payer billing regulation . ESSENTIAL DUTIES AND RESPONSIBILITIES: Develops Audit and Education Programs Abstracts relevant clinical and demographic information from the medical record to assign current ICD and CPT codes in accordance with coding and reimbursement guidelines. Codes with an accuracy of 97% based on QA internal reviews Performs Evaluation and Management (E&M)...

Are you a detail-driven coding professional who thrives on accuracy, compliance, and making an impact behind the scenes of patient care? If so, we want to hear from you! We are currently hiring Medical Coding Specialists – (certified or non-certified) to join our dynamic and collaborative team supporting University Physicians. This is your opportunity to work in a mission-driven environment where your expertise directly supports quality care and operational excellence. 💼 What You’ll Do Review complex clinical documentation and diagnostic results to accurately assign: ICD-10-CM (diagnoses) CPT codes (procedures) Modifiers for services Ensure maximum reimbursement and regulatory compliance Assist with audits to identify coding issues, denials, and reimbursement opportunities Serve as a liaison between departments and third-party payers Support providers, residents, and staff with documentation and coding guidance Help...

Position Summary At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare.  As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. Under the direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding accuracy as well as perform screening referrals for clinical support of coded diagnoses. Responsibilities: Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing. Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides. Collaborates with physician reviewers, as needed. Ability to prioritize and organize workload and complete tasks independently....

Overview Top candidates will have experience with Oncology Coding.   As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA   This position is responsible for abstracting, coding, and interpreting of outpatient clinic and provider services for professional and/or facility billing. This position uses coding knowledge to abstract and record data from medical records and provides support to areas related to documentation and coding. This position codes and charges complex or specialty services and may serve as a resource for other coders. This position is not responsible for...

JOB TITLE: Certified Billing Specialist DEPARTMENT: Business Office LOCATION: Anchorage, AK STATUS: Full-Time, On-Site CERTIFICATION REQUIRED:  Active Certified Professional Biller (CPB) or Certified Coder (CPC) **SIGN ON BONUS: $3,000 (2yr commitment) ** About the Role Alaska Heart & Vascular Institute (AHVI) is seeking an experienced and detail-oriented Billing Specialist  to join our in-office Business Office team in Anchorage. This role is ideal for a billing professional who thrives in a collaborative environment and is looking to deepen their expertise in cardiology billing across outpatient, inpatient, and ambulatory settings. As part of a highly knowledgeable team of coders, billers, and clinical professionals, you’ll play a key role in ensuring accuracy, compliance, and exceptional service in a fast-paced, high-volume environment. SUPERVISION RECEIVED: Reports to Business Office Manager. SUPERVISION EXERCISED: None ESSENTIAL...

Job Description Nemours is seeking a Sr. CDM Specialist  in Orlando, FL This position is responsible for: assistance in maintenance of Charge Description Master (CDM) within Nemours hospital revenue producing departments. Works with the CDM/HB Manager to ensure an accurate CDM and Coding process resulting in clean and compliant claims. Acts as liaison and problem solver for CDM issues with Administration, insurance companies, charge capture departments, Health Information Management, Utilization Management, Recovery Auditors, Managed Care, Corporate Compliances, and Central billing Office (CBO).  Responsibilities: Responsible for the coordination of ongoing CDM consistency within revenue producing departments. Includes maintaining accurate descriptions, coding, in-activations, and revenue code assignments.      Demonstrate and incorporate a working knowledge of the hospital's billing and coding software applications as related to coding...

Job Summary Assigns appropriate ICD and CPT codes for reimbursement and statistical purposes. Follows ICD, CPT, CMS, and other regulatory coding guidelines. Abstracts clinical information from medical records for complete and accurate statistical documentation. Minimum Qualifications Minimum Education:   High School Diploma or Equivalent Minimum Years of Experience:   3 Years of Professional Coding Experience Covering Multiple Clinical and/or Surgical Specialties (Combination of Surgical, E/M, or other coding experience as approved by Director), which they Successfully Met Quality and Productivity Standards Substitutable Education & Experience (Optional):   None. Required Certifications/Licensure:   Active AAPC or AHIMA Coding Credential Required Training:   Experience working with CPT, ICD diagnosis coding; Experience with CCI edits; Experience with Medicare LCDs and NCDs; Understanding of state and federal regulations as well as payor...

Help safeguard accuracy, integrity, and regulatory compliance across our organization. We are seeking a skilled Compliance & Coding Audit Specialist to support the Corporate Compliance Program through detailed auditing, monitoring, and provider education related to coding, billing, and clinical documentation practices. What You’ll Do Conduct ongoing coding, billing, and documentation audits to ensure compliance with hospital policies and federal and state regulations Interpret medical records and related documentation using advanced coding knowledge to assess accuracy and risk Execute compliance audit assignments with a high degree of independence, confidentiality, and professional judgment Analyze findings, prepare audit documentation, and identify trends or improvement opportunities Present audit results directly to physicians and providers, delivering clear feedback and education on documentation and coding best practices...

JOB LOCATION:   Remote (Considering applicants residing in Georgia, Florida, Ohio, North Carolina, South Carolina, West Virginia, Utah, Arizona, and Missouri.) DEPARTMENT:   REVENUE CYCLE MEDICAL GROUP, SGMC Health SCHEDULE:   Full Time, 8 HR Day Shift, 8-5 Abstracts ICD-10 and CPT codes for Diagnosis and Procedures on professional services. Reviews and analyzes medical records verifying and coding the diagnosis, evaluation and management service, minor procedures, or other codes required for the completeness and accuracy of the record. Additionally, will code and/or review principal diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, any applicable supply, medication, and injectable drugs. Maintains communication with Management, Practice Manager, and Provider to ensure timely notification of identified documentation issues. Interact with other team members of the revenue cycle and provider clinics. Responsible for continuing education of...

Provider Coding Specialist Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region's largest health care provider, we are also one of our area's largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day. A Brief Overview Under the supervision of the Coding Supervisor, the Provider Coding Specialist is responsible for analyzing and assigning ICD-10-CM diagnostic codes, CPT, and HCPCS codes to professional surgical patient accounts, based on the medical information provided and consistent with regulatory guidance and best practices in the industry and Organization policy and procedure. Abides by the Standards of Ethical Coding as set forth by AHIMA and AAPC. Abstracting required clinical information from the medical record. Queries physicians as needed, to clarify documentation to ensure accurate code assignment. Organizes and prioritizes...